Attachment D - NGA Visistor Access Request Form.pdf

PDF 146 KB Posted

Attached to
NGA - Elevator Inspections
Solicitation number
HM157525R0004
Issued by

About this file

This is a site visit request form (Attachment D) for elevator inspections at three NGA facilities: NGA Arnold Facility, NGA Next West, and NGA St. Louis. The site visit is scheduled for March 11, 2025, at 9:00am CST, with arrival time at 8:30am CST.

The form requires visitor information including first name, middle initial, last name, suffix, nation of citizenship, ID type (preferably US Driver's License), ID number with state of issue, date of birth, and place of birth (city, state). The document is subject to the Privacy Act of 1974 and includes privacy protection requirements stating that contents shall not be disclosed except to those with direct need-to-know for official duties. The form appears to be a security screening document for contractors who will participate in the site visit related to the elevator inspection solicitation (HM157525R0004).

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UNCLASSIFIED

Attachment D

UNCLASSIFIED

Request for NGA Site Visit – Elevator Inspections @ NGA Arnold Facility, NGA Next West & NGA St. Louis

March 11, 2025, 9am CST. Arrive at 8:30am CST

Company Name _______________________

First MI Last Suffix Nation of Citizenship

ID Type* ID Number (indicate State of Issue, e.g.

MO XXXX-XXXX-XXXX)

Date of Birth

YYYY-MM-

DD

Place of Birth City, State

*Although several forms of ID are allowed, use “US Driver’s License” if available.

This document is subject to the Privacy Act of 1974: Contents shall not be disclosed, discussed, or shared with individuals unless they have a direct need-to-know in the performance of their official duties. Deliver this/these document(s) directly to the intended recipient. DO NOT drop off with a third party. DOD Directive 5400.11, “Department of Defense Privacy Program”, May 8, 2007.

File details come from the government source that posted it. Updated .