Attachment 9 - DL1818 Visitor Notification Form.pdf

PDF 130 KB Posted

Attached to
DDNV Vertical Lift Module Preventative/Corrective Maintenance Federal contract opportunity
Solicitation number
SP330025Q0088
Issued by
Defense Logistics Agency Distribution

About this file

Written by GovTribe AI ·

This is DLA Form 1818, a Visit Notification form used to control access to Department of Defense installations, buildings, and facilities, specifically for visits to the Defense Logistics Agency at Fort Belvoir, VA.

The form requires detailed visitor information including names, grade/rank, SSN, date of birth, state/country of birth, and security clearance details. It contains three main sections: basic visit information (dates, purpose, point of contact), visitor details, and security representative authorization. The form falls under the authority of Section 21, 50 U.S.C. 781 and Executive Order 10450, with disclosure being voluntary but necessary for facility access. This appears to be a blank template that would need to be completed by contractors or visitors requiring access to DLA facilities in relation to the vertical lift module maintenance contract.

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Text version

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PRIVACY ACT STATEMENT

VISIT NOTIFICATION

1. ACTIVITY TO BE VISITED

AUTHORITY:

PRINCIPAL PURPOSE:

ROUTINE USES:

DISCLOSURE:DEFENSE LOGISTICS AGENCY

8725 JOHN J. KINGMAN ROAD

FT BELVOIR, VA 22060-6220

Section 21, 50 U.S.C. 781 et seq.; Executive Order 10450.

To control access to and movement on DoD installations, buildings, or facilities.

Used by General Services Administration Protective Service Personnel for access control and for any of the Blanket Routine Uses published by DLA.

Voluntary. However, failure to provide all the requested information may result in refusal to grant access to the installation, building, or facility.

DLA PRIVACY ACT SYSTEM NOTICE S500.50 DLA-I APPLIES

SECTION I

2. NAME OF REQUESTOR/PREPARER 4. TELEPHONE3. OFFICE CODE

5. DATE(S) OF VISIT 6. POINT OF CONTACT (at facility to be visited) 7. POC TELEPHONE

8. PURPOSE OF VISIT

SECTION II

9.

NAME(S) OF VISITOR(S)

(Last, First, MI)

10.

GRADE/RANK

11.

SSN

12.

DATE OF BIRTH

13.

STATE /COUNTRY OF

BIRTH

14.

CLEARANCE/DATE

GRANTED

15.

TYPE OF INVESTIGATION/

DATE

16. TYPED NAME OF SECURITY REPRESENTATIVE

SECTION III

18. ACTIVITY 19. TELEPHONE NUMBER 20. DATE17. SIGNATURE OF SECURITY REPRESENTATIVE

DLA FORM 1818, JUL 96 (EG)

FROM: TO:

PDF (DLA)

RequesterName:
OfficeCode:
FacPOC:
Phone:
POCPhone:
VisitedActivity:
VisitPurpose:
DateTo:
Visitor:
0:
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GradeRank:
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SSN:
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DOB:
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StateCountry:
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ClearDate:
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InvestDate:
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DateFrom:
SecRepName:
Activity:
ActPhone:
SecRepDate:
tVisitor:
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tcsControl:
addcsBtn:
ResetMe:
resetBtn:

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