Base Access Request Template.docx
DOCX document 177 KB Posted
- Attached to
- GT Wash Rack Upgrade & Maintenance
- Solicitation number
- FA480326Q0087
About this file
This is a Base Access Request Template used by the 20th Fighter Wing at Shaw Air Force Base to process visitor and contractor access to the installation. The form is a standard administrative document designed to collect personal information and sponsor accountability for individuals requiring base access, including their full legal name, date of birth, Social Security number, driver's license information, and U.S. citizenship status. The template establishes that the sponsoring government employee is responsible for ensuring visitors comply with all access protocols and for timely return or deactivation of DBIDS passes upon termination of access.
The form contains four key statements that sponsors must acknowledge: (1) responsibility for managing visitor passes and notifying Security Forces of any pass deactivations; (2) requirement to submit scanned documentation for non-U.S. citizens, including foreign visas, permanent resident cards, or employment authorization documents prior to visiting the Visitor Control Center; (3) sponsor obligation to inform visitors of Real ID Act compliance requirements for identification; and (4) specification that all requests must be submitted from a government email address to the designated 20 SFS/S-5V section email or fax or the request will not be processed. The template is marked as Controlled Unclassified Information (CUI) under the Privacy Act of 1974 and is used exclusively for processing criminal background history checks to determine base access eligibility.
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Text version
CUI
CUI
DEPARTMENT OF THE AIR FORCECUI
20th FIGHTER WING (ACC)
SHAW AIR FORCE BASE SOUTH CAROLINA
DATE: 12-Mar-26
MEMORANDUM FOR 20 SFS/S-5V
FROM:
SUBJECT:
WHO:
WHAT FOR:
WHERE:
If base wide give justification:
WHEN (ACCESS DATE/DAYS/TIMES):
SPONSOR NAME:
DOD EDPI:
CONTACT INFO:
The information below is protected under Privacy Act 1974 and will only be used to process Criminal Background History Checks to grant or deny access to Shaw AFB. It is further understood that anyone abusing approved privileges could, at a minimum, lose said privilege and possibly face criminal charges.
Full Legal Name (Last, First MI) Date Of Birth (Year/Mo/Day) Social Security Number
(XXX-XX-XXXX)
ST-DL #
(REAL ID Y/N)
U.S.
Citizen (Y/N)
PLEASE READ THE STATEMENTS BELOW
1. I UNDERSTAND THAT AS THE SPONSOR I AM RESPONSIBLE FOR THE PERSON(S) LISTED ON THIS FORM, AND FOR ENSURING THE ABOVE NAME INDIVIDUAL(S) TURNS IN THE DBIDS PASS OR RETRIEVE THE PASS ONCE THE INDIVIDUAL(S) ARE TERMINATED, QUIT, OR NO LONGER REQUIRES ACCESS. IF I AM NOT ABLE TO RETRIEVE THE PASS, I WILL NOTIFY SECURITY FORCES TO HAVE THE INDIVIDUAL(S) PASS DEACTIVATED IN DBIDS.
2. If you, as the sponsor, filled out the request and answered N for U.S Citizen please make sure you submit scanned in documents before coming to the VCC. **i.e.-FOREIGN VISA, PERMANENT RESIDENT CARD (Form I-551) & EMPLOYMENT AUTHORIZATION CARD (Form I-766) HOLDERS, ETC.
3. AS THE SPONSOR, I will inform my visitors they must have identification in compliance with the Real ID Act OR have a Federal ID in which cases they do not. If they do not, they will not be able to receive a pass from the VCC.
4. THIS FORM MUST BE SENT BY THE SPONSOR LISTED ABOVE FROM THEIR GOVERNMENT EMAIL AND RECEIVED AT THE EMAIL ADDRESSES/FAX NUMBER LISTED ABOVE IN THE 20 SFS/S-5V SECTION OR THE REQUEST WILL NOT BE PROCESSED.
CUI
CUI
CUICUI
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File details come from the government source that posted it. Updated .