B08 - IFB Atch 6 - NCIC Consent Form Instructions.pdf

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MOTCO Rail 1 Repair
Solicitation number
W9123821B0014
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This document provides instructions for completing a National Crime Information Center consent form required for visitor access to a military installation. The form collects individual information such as name, race, date of birth, address, and social security number. It also requires consent to conduct a criminal background check using the FBI database. The form can be used to grant one to four years of access depending on the boxes selected for recurring vetting. Sponsors are responsible for ensuring all information is accurately provided on the form and that individuals understand the authorization and liability associated with the background check results.

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NCIC CONSENT FORM (Required only for visitors who do not have a CAC or other Federal Government ID Card) - CAC holders must be working in the capacity of their CAC. Example: If John Smith is working for Bob’s Electric as an electrician but is in the Army Reserve and has a

CAC card, that would not be considered requesting access in the capacity of his CAC. He would submit NCIC Consent Form.

All information MUST be legible on this form. If it cannot be read, it will not get processed.

This NCIC Consent Form offers the ability for visitors to be vetted for up to four years of access. Vetting will occur annually for the years that are checked on the NCIC Consent Form.

*** Common mistakes

*** I (print full name; first, middle, last): PRINT the visitor's full name; First, Middle, Last ---- It must be in that order.

*** “One year only” will be the most common. For contracts that have a period of performance contract duration that does not exceed one year “One year only” should be selected. NCIC Consent Forms received that have other boxes selected will be returned for revision. Exceptions (contractors that expect to work at MOTCO in the future) must include a justification and be approved by MOTCO USACE Resident Engineer.

I give consent to the VCC conducting my criminal history check:

One year only: Vetting will be conducted initially for access (additional vetting MAY occur within the first year). Based on the vetting results, the visitor will be granted UP TO ONE year access (based on MOTCO 190-3-R1 MAY 2019). *** NCIC Consent form and vetting results will be shredded after one year***

I give consent to the VCC conducting my criminal history check for an additional:

“1” year: Vetting will be conducted initially for access, and will automatically be conducted after one year. Based on the vetting results, the visitor will be granted UP TO TWO years of access. *** NCIC Consent form and vetting results will be shredded after TWO years***

I give consent to the VCC conducting my criminal history check for an additional:

“2” years: Vetting will be conducted initially for access, and will automatically be conducted after two years. Based on the vetting results, the visitor will be granted UP TO THREE years of access. *** NCIC Consent form and vetting results will be shredded after THREE years***

I give consent to the VCC conducting my criminal history check for an additional:

“3” years: Vetting will be conducted initially for access, and will automatically be conducted after three years. Based on the vetting results, the visitor will be granted UP TO FOUR years of access. *** NCIC Consent form and vetting results will be shredded after FOUR years***

Here are a couple examples:

1) You have a contractor that will be working on a project with a contract duration of 18 months, and they wish to opt into recurring vetting.

a. The requestor will check mark the “Annual for ADDITIONAL “1” years” on the NCIC CONSENT FORM - May 2019 Fillable

2) You have a contractor that will be working on a project with a contract duration of 25 months, and they wish to opt into recurring vetting.

a. The requestor will check mark the “Annual for ADDITIONAL “2” years” on the NCIC CONSENT FORM - May 2019 Fillable

3) You have a contractor that will be working on a project with a contract duration of 25 months, and they do NOT wish to opt into recurring vetting.

a. The MOTCO 190-3-R1 will have access from whenever they will need access through 12 months (1-Jun-19 thru 31-May-20)

b. The requestor will check mark the “One year only” on the NCIC CONSENT FORM - May 2019 Fillable

c. At the expiration of the vetting year, a new 190-3 and NCIC Consent Form will be required for further access.

2) You have a contractor that will be working on a project with a contract duration of 9 months, and they wish to opt into recurring vetting.

a. This is not permissible.

3) You have a contractor that will be working on a project with a contract duration of 9 months, and they wish to opt into recurring vetting because they work on a multitude of projects on MOTCO and can reasonably justify why they think they will need recurring access.

a. An exception may be granted in this case. Justification must be submitted in the MOTCO Base Access Request Memorandum.

***** OPTING OUT OF RECURRING VETTING MUST BE DONE IN WRITING

THROUGH MOTCO SPONSOR *****

***** IT IS STRICTLY UP TO THE REQUESTOR IF THEY WISH TO OPT INTO

RECURRING VETTING *****

Signature of Requestor: This is where the individual requesting access signs.

Race: Enter the visitor's race American Indian, Asian Indian, Black, Cambodian, Chinese, Filipino, Guamanian, Hawaiian, Hispanic/Mexican/Latin, Korean, Laotian, Other, Other Asian, Pacific Islander, Samoan, Vietnamese, White

***Human is not an acceptable answer and will be returned to sponsor to have fixed***

Date: Enter the date the form is being signed.

Date of Birth: Enter the visitor's date of birth.

*** Place of Birth (City and State): Enter the city and state of the visitor's place of birth. This is very important and the main reasons forms are returned for correction. If the place of birth is outside the United States it also must contain a city. For example: Tijuana, Mexico

Gender: Enter the visitor's gender.

Social Security Number: Enter the visitor's Social Security Number.

DL#/State: Enter the Visitor’s driver’s license number and state.

Address: Enter the visitor's CURRENT PHYSICAL address.

Company Name: Enter the visitor's company name.

Telephone: Enter the visitor's contact information.

It is recommended you type the information on the NCIC and then have the visitor sign the document.

If you send a NCIC form that is not properly filled out, changes cannot and will not be made to

it. The NCIC Consent Form is authorization to perform a criminal background check utilizing the Federal Bureau of Investigation (FBI) criminal database. Sponsors are not authorized to make alterations to a signed document. They will be held legally liable for the information it contains and the results.

Remember the sponsor is required to review and proofread the request PRIOR to sending it.

Errors cause delay. Best practice: Send it right the first time.

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