EAL Form.pdf
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About this file
The document is an Entry Authorization Listing (EAL) form for Columbus Air Force Base, used to authorize and track entry of visitors to the installation. The form includes a detailed Privacy Act Statement explaining the legal authority (AFI31-101, Integrated Defense and 5210.4]-M_AFMAN_31-108) for collecting visitor information. Key instructions require the form to be submitted to the 14th Security Forces Squadron at least 3 duty days prior to an event, with visitors' personal details including last name, first name, driver's license number, state, SSN, and date of birth. The form allows for entry authorization at specific gates (East, South, or Vehicle Inspection Area) and has space to document the event name, start date, start time, and expiration date (maximum of 6 months). A point of contact (POC) must provide their grade, name, contact numbers, and signature when submitting the form.
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Text version
COLUMBUS AFB FORM | PAGE OF
ENTRY AUTHORIZATION LISTING (EAL) DATE (SFS use only)
PRIVACY ACT STATEMENT
AUTHORITY: AFI 31-101, Integrated Defense and 5210.4]-M_AFMAN_31-108
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 proved 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 statue, rule, regulation, order issued pursuant thereto.
TO
14 SFS/S5B
TODAYS DATE
LOCATION OF EVENT LOCATION PHONE NUMBER
START DATE START TIME OF EVENT
NAME OF EVENT (Ex: Class 22-10 Graduation, LTCOL Doe’s Retirement, etc.) EXPIRATION DATE (Max of 6 months)
AUTHORIZED GATE FOR ENTRY (Check all that apply)
EAST SOUTH VEHICLE INSPECTION AREA
POC GRADE POC LAST NAME POC FIRST NAME SIGNATURE
DUTY PHONE NUMBER HOME PHONE NUMBER CELL PHONE (Optional)
INSTRUCTIONS: Please list personnel (neatly printed or typed). EALs will be turned in to the 14th Security Forces Squadron, Operations Superintendent or the Security Forces Visitors Center (SFVC), building 99, at least 3 DUTY days prior to the event. Any questions can be directed to the Visitors Center, ext. 2111, or the Operations Superintendent, ext. 7123.
LAST NAME FIRST NAME DRIVER’S
LICENSE NUMBER STATE SSN DATE OF BIRTH
YYYYMMDD
COLUMBUS AFB FORM | PAGE OF
Authenticated By: (Rank, Last, First, M., Office Symbol): Signature:
SFS use only SFS use only
| ENTRY AUTHORIZATION LISTING EAL: |
| DATE SFS use only: |
| TO 14 SFSS5B: |
| TODAYS DATE: |
| LOCATION OF EVENT: |
| LOCATION PHONE NUMBER: |
| START TIME OF EVENT: |
| NAME OF EVENT Ex Class 2210 Graduation LTCOL Does Retirement etc: |
| EXPIRATION DATE Max of 6 months: |
| AUTHORIZED GATE FOR ENTRY Check all that apply EAST SOUTH VEHICLE INSPECTION AREA: |
| undefined: |
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| POC GRADE: |
| POC LAST NAME: |
| POC FIRST NAME: |
| SIGNATURE: |
| HOME PHONE NUMBER: |
| LAST NAMERow1: |
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| Authenticated By Rank Last First M Office Symbol: |
| Signature: |
| Cell Phone: |
| Duty Phone: |
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