BASE Elizabeth City Visitor Request Form_Blank.xlsx
XLSX spreadsheet 106 KB Posted
- Attached to
- Air Station Elizabeth City RCB Bathroom Remodel
- Solicitation number
- 70Z08126QELIZ0003
About this file
This is a blank visitor request form template for Base Elizabeth City, a U.S. Coast Guard installation in Elizabeth City, North Carolina. The form collects standard visitor information including name, date of birth, driver's license details, citizenship status, organization, purpose of visit, arrival and departure times, and sponsor information. All visitor requests must be submitted no later than three working days prior to the scheduled visit, with foreign visitors requiring submission at least thirty days in advance. Completed forms should be sent to d05-smb-baseecityvisitors@uscg.mil with the sponsor's contact information included.
The form references Base Elizabeth City Instruction 5512.1B for additional requirements and provides contact information for multiple tenant command security officers across various Air Station Elizabeth City departments, including the Aviation Technical Training Center, Aviation Logistics Center, Air Station Elizabeth City, Boat Station Elizabeth City, and USCG Aviation Projects Acquisition Center. The form notes that visitor requests are monitored daily and applicants will be contacted if they do not meet base entry criteria as defined in the referenced instruction or DCMS denial criteria. Instructions emphasize that the completed form contains personally identifiable information and should be saved securely before submission.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Building 54 Bathroom Rehab RFIs.docx | DOCX document | |
| SF25A-23a.pdf | ||
| SF1442.pdf | ||
| Construction Clause.docx | DOCX document | |
| DOL-NC20260056.pdf | ||
| SF25-23a.pdf | ||
| SOW - B54 Rehab Bathrooms.docx | DOCX document |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Sheet1
| Base Elizabeth City Visitor Request |
| For questions, contact your Command Security Officer or Base Coast Guard Police Dept. at (252) 335-6588. |
***All requests shall be submitted no later than 3 working days prior to visit.*** Reference BASEECITYINST 5512.1B for additional information and requirements.
LAST NAME FIRST NAME MIDDLE INITIAL SUFFIX DATE OF BIRTH DL STATE DL# CITIZENSHIP (US/FOREIGN)
| VISITOR ORGANIZATION: | |
| PURPOSE OF VISIT: | |
| PLACE OF VISIT: | |
| ARRIVAL: | |
| DEPARTURE: | |
| SPONSOR'S NAME: | Steven J. Carr (Josh) |
| SPONSOR'S COMMAND/AFFILIATION: | Base FED |
| SPONSOR'S CONTACT INFORMATION | MS Teams: 206-836-4077 |
| COMMENTS BELOW: |
| ***FOREIGN VISITORS MUST BE SUBMITTED NO LESS THAN THIRTY DAYS PRIOR TO AN OFFICIAL VISIT*** | ||
| For more information and/or guidance, contact your Tenant Command Security Officer | ||
| Base Elizabeth City and Tenant Command CSO's: | ||
| Base Elizabeth City: | MEC Kealiinohomoku, Brandonn | (252)335-6855 |
| Aviation Technical Training Center (ATTC): | ASTC Linehan, Michael | (252)335-6917 |
| Aviation Logistics Center (ALC): | Mr. Smith, Stephen | (252)384-7173 |
| Air Station Elizabeth City: | OSC Brancaleone, Paul | (252)335-6761 |
| Boat Station Elizabeth City: | BM1 Jordan, William | (252)335-6086 |
| USCG Aviation Projects Acquisition Center (APAC): | LT Cortez, Miguel | (252)355-6279 |
| ***ALL VISITOR REQUESTS SHALL BE SENT TO THE FOLLOWING EMAIL:*** | ||
| d05-smb-baseecityvisitors@uscg.mil | ||
| Instructions: Left click on the email address and an email will auto-populate. Once all fields are filled out in this visitor request, save to a safe place as this contains PII and attach this form to the email. Once you send off a visitor request you do not need to follow up, all visitor requests are monitored on a daily basis. If a member does not meet Base entry criteria as defined in BASEECITYINST 5512.1B and DCMS denial criteria, you will be contacted and the visitor request will be denied pending a follow up request. If you have any further questions please feel free to contact the CGPD. |
mailto:d05-smb-baseecityvisitors@uscg.mil image1.emf image2.emf image3.emf image4.emf image5.emf
File details come from the government source that posted it. Updated .