ITO Attachment 1.0 - Base Access Memo.docx

DEPARTMENT OF THE AIR FORCE

HEADQUARTERS 96TH TEST WING (AFMC)

EGLIN AIR FORCE BASE, FLORIDA

Date

MEMORANDUM FOR 96 SFS/S-5B

FROM: Unit

SUBJECT: Request for Badge/Pass

1. The following individual(s) require access to ______________ (i.e., Eglin/Duke/7 SFG/6 RTB/NAVEOD) to perform official duties at Building _______ (must specify--not base-wide). Their duties will include __________________________ (provide brief description of their duties). All work will begin on (date) ___________and will be accomplished by (expiration date) _________________. The contract number (if applicable) is __________________________.

2. The individuals listed have been briefed that while on the installation, they must comply with all local laws and policies. Failure to comply will result in loss of base access. Each individual understands that they must go to the Security Forces Pass and Registration Office to receive their Contractor Identification Badge/Pass. They further understand they must have a valid driver's license/identification card, proof of current registration and insurance while driving on the installation.

3. When first arriving to the installation, the listed individual(s) will need (select one) an escort to area of work or visit, no escort, or will need to call sponsor before being allowed access to the installation.

4. I understand it is the unit/company responsibility to collect the badges of terminated employees and to collect the badges at the conclusion of the work that was to be accomplished. Further, I understand that we are responsible to turn the badges/passes in to the Security Forces Pass and Registration Office as soon as all work is complete.

5. The government sponsor of the above individual(s) is:

INSTRUCTIONS: Submit completed requests via encrypted email to 96sfs.s5b.passandreg@us.af.mil and allow 3 business days for processing. Note: Requests coming from outside DoD will use AMRDEC SAFE to send encrypted requests. Log in as a Non-CAC User at https://safe.amrdec.army.mil/SAFE .

PRIVACY ACT STATEMENT

Authority: 10 U.S.C. 8013, Secretary of the Air Force; 18 U.S.C. 922 note, Unlawful Acts note referring to the Brady Handgun Violence Prevention Act; 28 U.S.C. 534 note, Judiciary and Judicial Procedures, note referring to the Uniform Federal Crime Reporting Act; 42 U.S.C. 10601 et seq., Crime Victims Fund; and Amendment to Lautenberg, 18 U.S.C. 922(d) (9) Unlawful Acts; DoD Directive 7730.47, Defense Incident-Based Reporting System (DIBRS); Air Force Instruction 31-203, Security Forces Management Information System; and E.O. 9397 (SSN), as amended.

Purpose: Provides a direct interface with the National Crime Information Center (NCIC) and Integrated Automated Fingerprint Identification System (IAFIS) as hosted by the Federal Bureau of Investigations (FBI) via the Criminal Justice Information System (CJIS).

Routine Use: In addition to those disclosures generally permitted under 5 U.S.C. 552a(b) of the Privacy Act of 1974, these records contained therein may specifically be disclosed outside the Department of Defense (DoD) as a routine use pursuant to 5 U.S.C. 552a(b)(3) as follows: To the Department of Justice for criminal reporting purposes and as required by the Brady Handgun Violence Prevention Act.

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