Attachment_-_C _Foreign_National_Data_Card.docx
DOCX document 24 KB Posted
- Solicitation number
- DE-SOL-0005090
About this file
Foreign National Data Card
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Amendment_001.pdf | ||
| IFB_Letter.pdf | ||
| DE-SOL-0005090.pdf | ||
| Attachment_B_-_Drawings.pdf | ||
| Attachment_A_-_Specifications.pdf |
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
WAPA F 3000-72#
(6/03)
FOREIGN NATIONAL DATA CARD
FOR UNCLASSIFIED FOREIGN VISITS AND ASSIGNMENTS
TO WESTERN AREA POWER ADMINISTRATION
Please print clearly
Attachment - C
WAPA Form 3000-72 Foreign National Data Card
DE-SOL-0005090
INSTRUCTIONS FOR PREPARING Foreign National Data Card for Unclassified Foreign Visits and Assignments to WAPA (WAPA F 3000-72#- 6-03)
Routing of Form:
|_|1. Requestor- Meeting host initiates the form at least 30-45 days before planned visit |_|2. Regional Manager (or Acting Official) for approval signature |_|3. Original to Regional Safety and Security Office (The Safety and Security office reviews and sends to Pam Moody- CSO) |_|4. Pam Moody (CSO- A7700) (Conducts required back-ground checks and approves visit) |_|5. Approval sent to Regional Safety and Security Officer |_|6. Regional Safety and Security Officer notifies host and front desk personnel of approval/denial
To allow time for background checks, this form must be completed at least 30 days for non-sensitive countries visitors, and 45 days for visitors from sensitive countries.
For more information and a list of sensitive countries go to: http://www.cso.wapa.gov/cpo/3700/SECURITY/fva.htm
(Failure to complete this approval process may result in denial of visit.)
Section A – PERSONAL DATA INFORMATION
| BLOCK 1. | Employee name: Last name; first name, middle name |
| BLOCK 2. | Select Male or Female: Place a check mark in the appropriate box |
| BLOCK 3. | Country of Birth: Spell out. No abbreviations |
| BLOCK 4. | City of Birth: Spell out. No abbreviations |
| BLOCK 5. | Permanent Address: Self-explanatory |
| BLOCK 6. | Date of Birth: Month/Day/Year |
| BLOCK 7. | Social Security Number: Self-explanatory |
| BLOCK 8. | Country of Citizenship: Spell out. No abbreviations |
| BLOCK 9. | Passport/Visa/Immigration Number: One must be supplied |
| BLOCK 10. | Country of Issue of Passport/Visa/Immigration Number |
| BLOCK 11. | Expiration Date: of above issued document Month/Day/Year |
Section B – EMPLOYMENT DATA
| BLOCK 12. | International Agreement Code: If one exists the visitor will know it. Not required. |
| BLOCK 13. | Current Employer/Business Name: Self-explanatory |
| BLOCK 14. | Business Address: Self-explanatory |
Section C – VISIT DATA INFORMATION
| BLOCK 15. | Buildings/Sites to be Visited: Be specific (note: Must be escorted by host at all times) |
| BLOCK 16. | Request Date: Date host is submitting this request for approval |
| BLOCK 17. | Name and Signature of DOE Host: Must be a supervisor |
| BLOCK 18. | Purpose of Visit: State clear purpose |
BLOCK 19. Technological Area: Be very specific- DO NOT abbreviate
| BLOCK 20. | Start Date of Visit: Month/Day/Year |
| BLOCK 21. | End Date of Visit: Month/Day/Year |
BLOCK 22. Authorized SES Manager Signature: Regional Manager or SES.
BLOCK 23. Authorized Approval Signature Pam Moody –visit not approved without this signature
Personal Data SECTION A
| 1. Name of Visitor: |
| (Last) |
| (First) |
| (Middle) |
| 2. Male |
| |_| |
| Female |
| |_| |
| 3. Country of Birth: |
| 6. Date of Birth: |
| 8. Citizenship: |
| / / |
4. City of Birth:
9. Passport/Visa/Immigration Numbers:
| 7. Social Security Number: |
| 5. Permanent Address: |
| 10. Country of Issue: |
11. Expiration Date:
Employment Data SECTION B
| 12. International Agreement Code: |
| 13. Current Employer/Business Name: |
14. Business Address:
Visit Data SECTION C
15. Buildings/Sites to be Visited:
| 16. Request Date: |
| 17. Name and Signature of DOE Host: |
18. Purpose of Visit:
19. Technological Area (Be very specific):
| 20. Start Date of Visit: |
| 21. End Date of Visit: |
22. Authorized SES Manager - Signature:
Date:
23. Security Office Approval - Signature:
Date:
File details come from the government source that posted it. Updated .