B.01. Solicitation W81K00-21-Q-0259 Attachment 5-HBSS Waiver Template.pdf

HBSS Waiver Request

DATE:

All fields or sections are required to be filled out/completed before request is reviewed.

Per USCYBERCOM OPORD 16-0080, FRAGO 1, waiver requests must be submitted for approval for systems or networks that cannot be modified to use Endpoint Security tools or any of its components due to exemption criteria listed in Section 3.C.3.D of this OPORD. Waiver requests must be sent to the Combatant Command, Service, Agency or Field Activity (CC/S/A/FA) J3 (or equivalent Operations Leadership) for review and approval prior to submitting to USCYBERCOM. The CC/S/A/FA J3 will ensure the appropriate Authorizing Official (AO) has approved the request, and will forward the request and exempted system's ATO on to USCYBERCOM.

CC/S/A/FA (i.e. CENTCOM, Navy, DFAS, etc.)

Sub Organization Point of Contact Information:

Full Name Job Title and Grade/Rank Office Symbol/Department Phone Number (DSN & COMM) E-mail Address (SIPR/NIPR)

Organization requiring waiver or exemption

HBSS module(s) or directive(s) requiring waiver:

ACCM DCM HIPS PA Rollup

Event Feed OAM RSD Other_______ (Anti-Virus is required)

Total number of hosts affected by waiver: Unclassified: Classified:

Certification and Accreditation expiration date for affected systems or network: Unclassified: Classified:

Ensure the following are attached/included:

(ensure documents are correctly classified and handled)

Host/Network technical information (e.g. Network diagrams, IP ranges, computer names) Plan Of Action and Milestones

Waiver Request Submission Information

(1) Identify system, or network, that is not capable of supporting Endpoint Security tools / HBSS as directed (i.e., System Name and brief description):

(2) Identify the Endpoint Security tools / HBSS modules which cannot be installed or supported as directed (e.g. HIPS 8 Patch 4, RSD 4.7.2, ePO 4.6.8) including specific module versions:

(3) Identify the reason(s) why specified system or network is not capable of supporting Endpoint Security tools / HBSS directives (i.e., technical, resource, capability, and/or time constraints):

(4) Provide any supporting data and test results that show Endpoint Security / HBSS modules or directives cannot be supported:

(5) Mission Impact if waiver is not approved:

(6) Other mitigation techniques that will be put in place in the interim to protect the system, or network, in question:

(7) A Plan of Action and Milestones (POA&M) are required for waivers with expected completion dates. If no POA&M is included, provide justification for why the use of Endpoint Security tools / HBSS is infeasible.

Approval Signatures

CC/S/A/FA J3

(Full Name, Grade/Rank, Title)

CC/S/A/FA J3 Signature (manual or digital)

CC/S/A/FA Authorizing Official (Full Name, Grade/Rank, Title)

CC/S/A/FA Authorizing Official's Signature

(manual or digital)