Base Pass Template.pdf
PDF 83 KB Posted
- Solicitation number
- FA483026Q0032
About this file
This document is a memorandum template for requesting installation access to Moody Air Force Base, Georgia, issued by the 23rd Security Forces Squadron.
The request form is used by unit sponsors to obtain passes for personnel to access the installation for specified purposes. Sponsors must provide the full names, dates of birth, complete Social Security numbers, driver's license information, and countries of citizenship for all personnel requiring access. The sponsor must clearly state the reason for the request, location of the event, date and time, and duration of the visit. The sponsoring officer, identified by rank, name, and duty title, is responsible for all sponsored personnel while on the installation and acknowledges that special functions may be curtailed or terminated with minimal notice due to security threats or Force Protection Condition (FPCON) declarations requiring enhanced defense measures. The document is classified as Controlled Unclassified Information (CUI) with privacy controls and is distributed only to federal contractors (FEDCON). The point of contact for questions is the sponsoring officer identified in the memorandum.
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Text version
CUI
DEPARTMENT OF THE AIR FORCE
23D SECURITY FORCES SQUADRON (ACC)
MOODY AIR FORCE BASE GEORGIA
CUI
Controlled by: 23 SFS CUI Category: PRVCY Distribution/Dissemination Controls: FEDCON POC: Rank First Name Last Name/(XXX) XXX-XXXX
DD MM YY
MEMORANDUM FOR 23 SFS/S5
FROM: Unit/Office Symbol or Person/Company Requesting Access
SUBJECT: Request for Installation Access (Title of Function)
1. I am requesting a pass to sponsor the following personnel to Moody Air Force Base, Georgia for the purpose of state the reason for the request, location of event, date and time of event and duration of event:
Full Name (as shown on government issued identification)
DOB
(MM/DD/YYY)
Full SSN Driver’s License/State of Issue
Country of Citizenship
2. If you have any questions or concerns I, Rank Last Name, First Name can be reached via telephone at (XXX) XXX- XXXX. As the sponsor, I understand that I am responsible for the personnel listed above while on the installation. Additionally, I understand all special functions may be curtailed or terminated with little or no warning due to security threats or when an FPCON is declared requiring increased defense measures.
FIRST NAME MI. LAST NAME, Rank, USAF Duty Title
File details come from the government source that posted it. Updated .