Attachment_3_-_EAL_Form.docx

FOR OFFICIAL USE ONLY

EAL Instruction Sheet

Submit all EALs at least three duty days prior to the day requested.

Fill in all information highlighted in YELLOW in the memorandum, then UNHIGHLIGHT it. Circle multiple choice answers (or strikeout non-answers) where needed.

Read all RED notes in memorandum and then delete notes

Fill out personal data in the EAL following the example, including the codes with the requested level of access

For visitors on OFFICIAL BUSINESS that will receive ESCORTED access (V badge), the second endorsement (21 SW/CC approval) is NOT REQUIRED

For all UNESCORTED (T Badge) requests, special visits (ESCORTED, V badge), or tours (ESCORTED, V badge), the second endorsement must be signed by the 21 SW/CC after background checks have been accomplished by 21 SFS/S-5E personnel

For all EALs, visitors must be at a minimum of 10 years old. Visitors must be able to walk unassisted up three flights of stairs and a distance of 1/8 of a mile.

Once the entire form is filled out, send via encrypted email to 21 SFS Visitors Center (visitorscenter@us.af.mil)

If unable to encrypt to the workflow, contact 21 SFS VCC at 474-2315 for authorized personnel.

If any mistakes are found, the EAL will be returned to requesting agency for corrections. Pen and ink corrections are not authorized; therefore, a new EAL must be generated

Additions must be submitted on a new EAL

For Foreign Nationals in the Social Security Block please enter Passport number, Green Card Number, etc. if SSN is not available.

Do not include this instruction sheet or the ‘code’ sheet at the end when submitting.

UNIT/SPONSOR ORGANIZATION

LETTERHEAD

Version 1.5A Version 2.1

This questionnaire is intended to assist in the completion of Entry Access List Memo.

Please verify the output for accuracy.

Who is your Point of Contact on Cheyenne Mountain AFS?

POC Name

POC Phone Number

POC Phone Number

POC Office Symbol

POC Office Symbol

What is the Type of the Visit? (Official Visit, T-Badge, SFR)

Choose a type. >>>

What is the specific reason of the visit?

Describe the purpose of your visit

What is the Start Date of the Visit?

Click here to enter a date. Dropdown >>>

What is the Finish Date of the Visit?

Click here to enter a date. Dropdown >>>

How many visitors are in the group?

Enter the Number of Visitors.

MEMORANDUM FOR 21 SFS/S-5E

FROM: POC Office Symbol POC Name POC Phone Number

SUBJECT: Entry Authority List (Choose an item)

1. The individuals listed on page 3 are visiting your installation from and require access Click here to enter a date. thru Click here to enter a date. to the areas, as noted below. In support of Describe the purpose of your visit. The EAL consists of this memorandum, a table of applicable codes and a list of Enter the Number of Visitors. Names of visitors in alphabetical sequence. Each unescorted individual who requires access to classified information has a Classified Information Nondisclosure Agreement, Standard Form 312 on file. All clearances have been verified through the Joint Personnel Adjudication System.

2. CAMERAS AND PICTURE TAKING: All visitors must have a Camera Use Request memorandum endorsed by 21 CS/IA and 21 SFS/S-5E. The memorandum must be coordinated and completed prior to the visit. The individual authorized to take pictures must carry the memorandum at all times, while inside the restricted area. In accordance with MSGOI 33-200, Cheyenne Mountain Air Force Station Portable Electronic Device Usage all pictures taken during the visit/tour must be reviewed by 21st Security Forces personnel prior to departure.

3. All visits to missions centers located within the Cheyenne Mountain Complex must be coordinated with the owning unit, POC Name / POC Phone Number.

4. This EAL expires 2359 local time, Click here to enter a date.

Attachments:

1. Entry Authority List

1st Ind, 21 SFS/S-5E, Click here to enter a date., Entry/Access Authority List

MEMORANDUM FOR 21 MSG CC/DD

1. Individual(s) do/do not meet security requirements.

2. Individual(s) do/do not meet the minimum (10 yrs.) age requirements as defined by MSG OI 31-7 for entry into the Restricted area.

2d Ind, 21 MSG/CC/DD Click here to enter a date., Entry/Access Authority List

MEMORANDUM FOR 21 SFS S5/E

(Individual(s)) are/are not authorized:

Unescorted “T” badge of the Cheyenne Mountain Restricted Area.

X

Escorted Entry (V-Badge) of the Cheyenne Mountain Restricted Area.

Authenticated by SFS Personnel (Name/Rank):__________________________________________________________

Authenticator Signature:________________________________________________________________

Date/Time:________________________________________________________________ Entry Access List Questionnaire

DEPARTMENT OF THE AIR FORCE

21ST SPACE WING (AFSPC)

Version 2.1

Version 2.1 image2.emf

Microsoft_Word_Document.docx

Entry Authority List (EAL)

PRIVACY ACT

Authority: AFI 31-101, Integrated Defense

Purpose: Verification of authority to enter a designated area.

SSN: Is used for further identification of an individual.

Routine Use(s): Entry Controllers will use the SSN or Controlled Picture ID (CPID) number as a means to verify a person is allowed to enter a designated area.

Disclosure: Disclosure is voluntary. Failure to disclose required information will result in that person not being allowed to enter a designated area.

BLOCK I. Personal Data

Last Name

First Name

MI.

Rank

(OFF/ENL/CIV)

Date of Birth yyyymmdd

FULLSSN or

Passport/Service Number

Badge # (AF1199/AFECC) / Place of Issue

Clearance

Access

Codes

BILKO

RUSSEL

N

ENL

19700101

XXX-XX-XXXX

12345

TS

Refer to last page for

Last

Entry

Appropriate access code

****IMPORTANT- In the row immediately following the last name, type “LAST ENTRY” in the “Last Name” field****

The information herein is For Official Use Only (FOUO) which must be protected under the Freedom of Information Act of 1966 and Privacy Act of 1974, as amended. Unauthorized disclosure or misuse of this PERSONAL INFORMATION may result in criminal and/or civil penalties image3.emf

Microsoft_Word_Document1.docx

BLOCK II. Codes

A

Access to NC2-ESI Category D Information

B

Access to NC2-ESI Category D and C Information

C

Access to NC2-ESI Category D, B and C Information

D

Access to TOP SECRET Critical Nuclear Weapons Design Information (CNWDI)

E

Access to SECRET Critical Nuclear Weapons Design Information (CNWDI)

F

Access to NATO CONFIDENTIAL

G

Access to NATO SECRET

H

Access to COSMIC TOP SECRET

I

Access to NC2-ESI Category C and TOP SECRET Information

J

Access to Inspect Unit Military Deception Program/Activities

K

Access to Formal Cryptographic Materials and Procedures

L

Access to NATO CONFIDENTIAL ATOMAL

M

Access to NATO SECRET ATOMAL

N

Access to COSMIC TOP SECRET ATOMAL

O

Access to Restricted Data/Formerly Restricted Data

P

Authorized to observe all crew, EWO and changeover procedures to include control documents. Authorized to inspect positive control authenticator procedures and observe a physical inventory of sealed positive control authenticator documents, coded switch Permissive Action Link (PAL), and associated materials as authorized in EAP-STRAT,VOL III and EAP-STRAT, VOL III (Appendix B)

Q

Authorized to observe code handling procedures as described in EAP-STRAT, VOL III (Appendix B)

R

Authorized UNESCORTED entry into Protection Level 1, 2, 3 and 4 Restricted Areas

S

Authorized UNESCORTED entry into Protection Level 2, 3 and 4 Restricted Areas

T

Authorized UNESCORTED entry into Protection Level 3 Restricted Areas

U

Authorized to hand carry items in all Restricted Areas

V

Authorized ESCORTED entry into exclusion areas

W

Authorized access to BIG SAFARI, SENIOR CROWN AND SENIOR YEAR information but not authorized access to Special Access Required (SAR) material within these programs unless identified by written authorization material within these programs unless identified by written authorization

X

Indicates the individual is authorized to observe/view the handling and procedural processes of effective and reserve editions of WS3 COMSEC material consisting of: CSMS, recode modules, rekey modules, and two-part universal release unlock code card set material consisting of CSMS, recode modules, rekey modules, and two-part universal release unlock code card set

Y

Initial certification under provisions of AFMAN 10-3902

Z

Interim-certified under provisions of AFMAN 10-3902

AA

Authorized access to fly in unit aircraft for operational evaluations during IG inspections

BB

Access to NC2-ESI Category E information

CC

Indicates individual is authorized access to SPECAT code words

DD

Indicates a Command Post inspector authorized to observe all USEUCOM/USAFE/NATO emergency actions procedures and COMSEC procedures/material used during evaluations including viewing of external portions of PCM IAW HQ USEUCOM EAP VOL IV, Chapter 1, paragraphs 7.A. through 7.B.(6)

7.A through 7.B.(6)

EE

Indicates the individual is authorized to observe/view the handling, accountability, transfer, inventory, processing, storage, and destruction of two- person control material IAW HQ USEUCOM EAP VOL IV, Chapter 1, paragraphs 7.A through 7.B.(6)

FF

Indicates the individual is authorized to inspect the handling, accountability, transfer, inventory, processing, storage, and destruction of conventional US and NATO COMSEC materials and required documentation is on file IAW AFI 33-201, Vol 2

US and NATO COMSEC materials and required documentation is on file IAW AFI 33-201, VOL 2

CM1

Authorized ESCORTED entry into Protection Level 1, 2, 3 and 4 Restricted Areas image1.png