EAL Form.pdf

293 KB Posted

Attached to
B836 Replace Electrical in Airfield Lighting Vault
Solicitation number
FA302226R0021
Issued by

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This is an Entry Authorization Listing (EAL) form used by Columbus Air Force Base to authorize visitor and contractor access to the installation. The form is classified as Controlled Unclassified Information (CUI) and must be submitted to the 14th Security Forces Squadron, Visitors Control Center (Building 99), at least three duty days prior to an event.

The form requires the event sponsor to provide detailed information including the event name/company, event date and time, building location, authorized entry gates (East, South, or Vehicle Inspection Area), and an expiration date not to exceed six months. The sponsor must list all authorized personnel with their full names, driver's license numbers and states, home addresses, full social security numbers, and dates of birth. All personnel on the EAL must possess REAL-ID compliant credentials to gain installation access per DAFMAN 31-103v3. The form emphasizes that sponsors are held fully responsible for all actions taken by their guests and visitors, with potential consequences including termination of sponsor privileges and administrative disciplinary actions. As of January 8, 2026, only digital EALs will be accepted. The sponsor must annotate "///LAST ITEM///" below the final name on the list and notify the Event Control Center at (662) 434-7128 upon event conclusion to certify all guests have departed the installation.

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COLUMBUS AFB FORM PAGE OF

CONTROLLED UNCLASSIFIED INFORMATION (CUI)

CUI

ENTRY AUTHORIZATION LISTING (EAL) AUTHENTICATED DATE (SFS use only)

PRIVACY ACT STATEMENT

AUTHORITY: AFI 31-101, Base Defense Operations

PURPOSE: Information collected by Security Forces personnel will be used to authorize entry to persons shown on the entry request for the specific purpose provided by the sponsor. Information will also be used to notify persons designated as the visitor sponsor of arrival and other pertinent information relating to entry on the installation. Information will be used to monitor installation visits and provide entry authority with a source document to validate authorized entry.

Information can be stored manually or digitally and will be removed as a current information resource when its purpose has been served.

ROUTINE USES: In addition to those disclosure generally permitted under 5 U.S.C. 552a(b) of the Privacy Act, these records or information contained therein may specifically be disclosed outside the DoD as a routine use pursuant to 5 U.S.C 522a(b)(3) as follows:

The ‘Blanket Routine Uses’ published at the beginning of the Air Force’s compilation of systems of records notices apply to this system.

DISCLOSURE: Disclosure of requested information is optional. Failure to provide all or parts of information requested can result in denial of installation entry.

Records may be disclosed to applicable Federal, State, or local agency charged with the responsibility of investigating or prosecuting a violation or enforcing a statute, rule, regulation, order issued pursuant thereto.

TO

14 SFS/S5B

TODAYS DATE

ADDRESS OF EVENT BUILDING NUMBER OF EVENT

START DATE (DD MMM YYYY) START TIME (HHMM)

NAME OF EVENT AND/OR COMPANY EXPIRATION DATE (Max of 6 months)

AUTHORIZED GATE FOR ENTRY (Check all that apply)

EAST SOUTH VEHICLE INSPECTION AREA

POC GRADE/RANK POC LAST NAME POC FIRST NAME POC SIGNATURE (Mandatory)

DUTY PHONE NUMBER ON CALL PHONE NUMBER SFS AUTHENTICATION SIGNATURE

INSTRUCTIONS: Please list personnel (WE WILL ONLY ACCEPT DIGITAL EALS AS OF 8 JAN 2026). EALs will be turned in to the 14th Security Forces Squadron, Visitors Control Center (Bldg. 99), at least 3 DUTY days prior to the event. Any questions can be directed to the Visitors Center at 434-3161 / 434-7133 or by email at 14SFSS5B@us.af.mil. All personnel on the EAL MUST have a REAL-ID compliant credential to gain access to the installation IAW DAFMAN 31-103v3.

BY SPONSORING ALL INDIVIDUALS BELOW ON COLUMBUS AFB, YOU WILL BE HELD RESPONSIBLE FOR ALL ACTIONS TAKEN BY EAL GUESTS/VISITORS. THIS CAN INCLUDE TERMINATION OF SPONSOR PRIVILEGES AND ADMINISTRATIVE DISCIPLINARY ACTIONS.

BE SURE TO ANNOTATE “ ///LAST ITEM/// ” BELOW FINAL NAME ON EAL

Sponsors must notify the ECC (662) 434-7128 at the conclusion of the event and certify that all guests have departed the installation.

LAST, FIRST, MI

DRIVER’S

LICENSE NUMBER /

STATE

HOME OF

RECORD

ADDRESS

FULL SSN DATE OF BIRTH

DD MMM YYYY

COLUMBUS AFB FORM PAGE OF

CONTROLLED UNCLASSIFIED INFORMATION (CUI)

CUI

Authenticated By: (Rank, LAST, FIRST / Office Symbol):

SFS use only

Signature:

SFS use only

LOCATION OF EVENT:
LOCATION PHONE NUMBER:
START TIME HHMM:
NAME OF EVENT ANDOR COMPANY:
POC GRADERANK:
POC LAST NAME:
POC FIRST NAME:
DUTY PHONE NUMBER:
ON CALL PHONE NUMBER:
LAST FIRST MIRow1:
DRIVERS LICENSE NUMBER STATERow1:
HOME OF RECORDD ADDRESSRow1:
FULL SSNRow1:
DATE OF BIRTH DD MM YYYYRow1:
LAST FIRST MIRow2:
DRIVERS LICENSE NUMBER STATERow2:
HOME OF RECORDD ADDRESSRow2:
FULL SSNRow2:
DATE OF BIRTH DD MM YYYYRow2:
LAST FIRST MIRow3:
DRIVERS LICENSE NUMBER STATERow3:
HOME OF RECORDD ADDRESSRow3:
FULL SSNRow3:
DATE OF BIRTH DD MM YYYYRow3:
LAST FIRST MIRow4:
DRIVERS LICENSE NUMBER STATERow4:
HOME OF RECORDD ADDRESSRow4:
FULL SSNRow4:
DATE OF BIRTH DD MM YYYYRow4:
LAST FIRST MIRow5:
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LAST FIRST MIRow6:
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LAST FIRST MIRow8:
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HOME OF RECORDD ADDRESSRow8:
FULL SSNRow8:
DATE OF BIRTH DD MM YYYYRow8:
Check Box1: Off
Check Box2: Yes
Check Box3: Off
LAST FIRST MIRow14:
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