Exhibit F - ASG-KU DES FORM 190-16.05 ENCLOSURE 10.pdf

Date:

Date:

Date:

Exception Type (Select All That Apply):

ASG‐KU EXCEPTION TO POLICY FORM

AUTHORITY: AR 190‐16, AR 600‐8‐14, AR600‐8‐104, USCENTCOM OPORD 10‐05 Antiterrorism, AFR 207‐4, OPNAVINST 5530.15a, MCO 5500.13a, DoD

1000.13p, ASG‐KU Installation Access Policy.

PRINCIPAL PURPOSE: To evaluate an applicant requesting an exception to specific requirements of ASG‐KU policies related to Installation Access.

ROUTINE USES: To establish a record for approval/disapproval of exception and to verify an applicant with an approved exception. Approved Prohibited Item

Exceptions must be carried at all times while on any ASG‐KU Installation and presented to military, law enforcement, or security personnel upon request.

DISCLOSURE REQUIREMENT ‐ THIS INFORMATION IS VOLUNTARY: Failure to provide the documentation and information requested, including a Foreign

Identification number, may result in the disapproval of this application. Exceptions may require additional screening, interview and background checks. Any derogatory information returned from the applicant's background investigation or failure to comply with screening/interview requirements may result in denial of exception and barment proceedings being initiated. Personal information such as Passport or Kuwait Civil ID number provide an individual with a unique identification and will be handled as OFFICIAL USE ONLY in accordance with Federal Statutes.

SECTION I ‐ POLICY EXCEPTION REQUEST

Description of Exception Requested:

Applicant's Name: Title and/or Position:

Kuwait Civil ID Number: Passport Number: Date of Birth (DDMMMYY): Nationality

Company Name: Justification Memo Attached (Enclosure 7):

SECTION II ‐ AUTHORIZED SIGNATORY RECOMMENDATION

Rank, First and Last Name: Signature:

Approved Exception Valid Until: Unit and Title:I am recommending the above exception and certify that I have verified the applicant's need and documentation for this exception.

SECTION III ‐ COUNTERINTELLIGENCE CONCUR/NONCONCUR FOR SMART DEVICES ONLY

Remarks:

Title, First and Last Name: Signature:

SECTION V ‐ ASG‐KU DES DIRECTOR APPROVAL/DISAPPROVAL

Approved Exception Valid Until: Title and/or Position:

Remarks:

Rank, First and Last Name: Signature:

Yes No

CONCUR NONCONCUR

APPROVED

DISAPPROVED

Enclosure 10 - ASG-KU DES FORM 190-16.05_Exception to Policy Form (1 July 2022)

Country of Concern Prohibited Items OCN Escort OTHER

SECTION IV ‐ IA OIC/NCOIC or DESIGNATE APPROVAL/DISAPPROVAL

APPROVED DISAPPROVED

Approved Exception Valid Until: Title and/or Position:

Rank, First and Last Name:

Date:Signature:

Remarks:

Smart Device

Smart Device Supplemental Form Attached (Enclosure 13):

Yes No

DBIDS # of Applicant