EAL Form.pdf

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Replace Radar Generator, B2021
Solicitation number
FA302226R0006
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This is a Columbus Air Force Base Entry Authorization Listing (EAL) form used to request visitor access to the installation. The form is classified as Controlled Unclassified Information (CUI) and is submitted to the 14th Security Forces Squadron, Visitors Control Center (Building 99), for processing.

The form requires submission at least three duty days prior to the scheduled event and must be submitted in digital format as of January 8, 2026. Required information includes the event name and location (Building B948 for the example shown—Repair Kiddie Pool Site Visit), event date and time, expiration date (maximum six months), authorized gate(s) for entry (East, South, or Vehicle Inspection Area), and point of contact information including grade/rank, name, phone numbers, and mandatory signature. The sponsor must list each visitor with their last name, first name, middle initial, driver's license number and state, home of record address, full Social Security number, and date of birth. The form emphasizes that sponsors are held fully responsible for all actions taken by guests and visitors, which can result in termination of sponsor privileges and administrative disciplinary actions. Sponsors must notify the Event Control Center at (662) 434-7128 upon event conclusion to certify all guests have departed the installation. Questions regarding the EAL process should be directed to the Visitors Center at 434-3161, 434-7133, or via email at 14SFSS5B@us.af.mil.

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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.

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: Columbus AFB Pool, Independence Dr, Columbus, MS 39705
LOCATION PHONE NUMBER: B948
START TIME HHMM: 10:00 CDT
NAME OF EVENT ANDOR COMPANY: Repair Kiddie Pool Site Visit
POC GRADERANK: E-3
POC LAST NAME: Sabado
POC FIRST NAME: McGil Jan
DUTY PHONE NUMBER: 662-434-3266
ON CALL PHONE NUMBER:
LAST FIRST MIRow1:
DRIVERS LICENSE NUMBER STATERow1:
HOME OF RECORDD ADDRESSRow1:
FULL SSNRow1:
DATE OF BIRTH DD MM YYYYRow1:
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Check Box1: Off
Check Box2: Yes
Check Box3: Off
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Date2_af_date:
Date5_af_date: 4/16/26
Date6_af_date: 4/15/26
Date7_af_date: 3/31/26
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