Attachment P - Temporary Gate Pass Form for site tour.pdf
PDF 178 KB Posted
- Solicitation number
- 240757
- Issued by
- Wayne County, Detroit City, Michigan
About this file
This document is a Temporary Gate Pass Disclaimer Form for the Detroit Metropolitan Wayne County Airport, associated with a Retail RFP #240757 issued by the Wayne County Airport Authority. The form is designed for individuals participating in a site tour, with provisions for collecting personal information and acknowledging Transportation Security Administration (TSA) requirements. Visitors, including minors accompanied by adults, are subject to standard TSA security guidelines and watch list screening procedures.
The form outlines key TSA information collection protocols under the authority of 49 U.S.C. section 114 and the Intelligence Reform and Terrorism Prevention Act of 2004. Providing personal information is voluntary, but refusal may result in additional screening or denial of transport/entry into sterile areas. The TSA reserves the right to share collected information with law enforcement or intelligence agencies under its published system of records notice. Individuals are directed to the TSA website (www.tsa.gov) for more details on privacy policies and impact assessments.
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Text version
ATTACHMENT P - TEMPORARY GATE PASS FORM FOR SITE TOUR
Detroit Metropolitan Wayne County Airport
Temporary Gate Pass Disclaimer Form
12/18
Visit Date: ____________________ Visit Duration: ____________________
Name: _____________________________________________________________________________ First Middle Last
Date of Birth: ____________________ Gender: Female Male Other
Country of Residence: _________________________________________________________________
Minors are eligible to participate. If under age 18, then they must be accompanied by an adult.
Visitors are subject to the same TSA security guidelines as ticketed passengers. Please visit www.tsa.gov for more information.
Disclaimer The Transportation Security Administration of the U.S. Department of Homeland Security requires us to collect information from you for purposes of watch list screening, under the authority of 49 U.S.C. section 114, and the Intelligence Reform and Terrorism Prevention Act of 2004. Providing this information is voluntary; however, if it is not provided, you may be subject to additional screening or denied transport or authorization to enter a sterile area. TSA may share information you provide with law enforcement or intelligence agencies or others under its published system of records notice. For more on TSA Privacy policies, or to view the system of records notice and the privacy impact assessment, please see TSA's Web site at www.tsa.gov.
Signature: ______________________________________________ Date: ________________
Wayne County Airport Authority - Retail RFP #240757 http://www.tsa.gov/ http://www.tsa.gov/
Disclaimer
| Visit Date: |
| Visit Duration: |
| Name: |
| Date of Birth: |
| Country of Residence: |
| Date: |
| Check Box1: Off |
| Check Box2: Off |
| Check Box3: Off |
File details come from the government source that posted it. Updated .