Att_19_EAL.xlsx
XLSX spreadsheet 21 KB Posted
- Attached to
- Mx & Repair Bldg 500 Federal contract opportunity
- Solicitation number
- FA4600-16-R-0012
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Attachment 19 - EAL
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Text version
EAL Blank Template
| Last, First, Middle Initial | Gender M/F | DOB (year month day) | Drivers License Number/State | State of Issue | Company Name | Nationality/Passport #/Visa #/INS # (if non us citizen) | Place of citizenship /Place of Birth | Citizenship date (if naturalized citizen) | Foreign continuous or routine contacts (name, country, relationship/method of contact) (list all) | |
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| PRIVACY ACT STATEMENT Authority: 10 U.S.C. 8013 and Executive Orders 13478 and 9397 as amended (SSN). Purpose: Information collected by PMO Security will be used to authorize | ||||||||||
| installation entry to persons shown on the entry authority listing for the specific purpose provided by the sponsor. Information will also be used to notify person(s) designated as the visitor | ||||||||||
| sponsor of arrival and other pertinent information relating to entry on the installation. Routine Uses: Records may be disclosed to applicable Federal, State, or local agency charged with the | ||||||||||
| responsibility of investigating or prosecuting a violation or enforcing/implementing a statute, rule, regulation, order issued pursuant thereto. | ||||||||||
| Disclosure: Disclosure of requested information is voluntary. Failure to provide all or parts of information requested can result in denial of installation entry. System of records number | ||||||||||
| F031 AF SF B, applies. Security Forces Management Information System (SFMIS) |
CONTRACTOR PERSONAL INFORMATION LIST FOUO FA4600-16-R-0012
Attachment 19
File details come from the government source that posted it. Updated .