Attachment 2 MARB Contractor Base Pass Request - Copy.pdf

PDF 206 KB Posted

Attached to
Security Systems Federal contract opportunity
Solicitation number
FA466421Q0005
Issued by
Department of the Air Force Reserve Command

View the file

Other files for this federal contract opportunity

Other files attached to Security Systems, newest first.
File Type Posted
Solicitation Amendment FA466421Q00050002.pdf PDF
Amendment FA466421Q0005-0001.pdf PDF
Attachment 1 Security Forces Pamphlet - Copy.pdf PDF
FA466421Q0005 MXG Security System.pdf PDF

On GovTribe

Work with this file on GovTribe

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

DATE SUBMITTED:

NAME (Last, First, MI) SSN DRIVER LICENSE #

Ensure individuals bring the following items to the Visitor Control Center (1) Real ID Driver’s License (if not a REAL ID, need second form of valid ID), (2) Registration and (3) Proof of insurance

***THIS FORM IS TO BE FILLED OUT AND SIGNED BY SPONSOR (DoD CAC HOLDERS ONLY)***

Privacy Act Statement PRIVACY ACT-1974 as Amended applies – This memo may contain information which must be protected IAW DOD 5400-11, and it is For Official Use Only (FOUO)

AUTHORITY: 10 U.S.C. 8013; 44 U.S.C. 3101; and EO 93397 PRINCIPAL PURPOSES: Used to record information and details of criminal activity which may require investigative action by commanders, supervisors, police, special agents, etc. ROUTINE USES: Information may be disclosed to Pass and Registration to determine base access. DISCLOSURE IS VOLUNTARY: SSN is used to positively identify the individual as a conduit to check past criminal activity records. Failure to provide the request information will affect your ability to gain access to

March Air Reserve Base, CA.

DL STATE DOB

This document contains FOR OFFICIAL USE ONLY(FOUO) information which must be protected under the Freedom of Information Act (5 U.S.C. 552 and/or the Privacy Act of 1974 (5 U.S.C. 552a). Unauthorized disclosure or misuse of this PERSONAL Information may result in disciplinary action, criminal and/or civil penalties. Contents not be disclosed, discussed, or shared with individuals unless they have direct need-to-know in the performance of their official duties.

Deliver this document directly to the VCC in person or e-mail the VCC ORG e-mail box. Only digitally signed and encrypted e-mail's from a .mil e-mail address will be accepted. E-mails from personal e-mail addresses will not be accepted.

**LISTS OF 10 OR MORE MUST BE SUBMITTED A MINIMUM OF 10 DUTY DAYS PRIOR TO VISIT**

**LISTS OF 9 OR LESS MUST BE SUBMITTED A MINIMUM OF 5 DUTY DAYS PRIOR TO VISIT**

Visitor Control Center Org e-mail: 452SFS.March.VCC@us.af.mil

452nd Security Forces Squadron Visitor Control Center March ARB Contractor Base Pass Request Sheet

TO

LOCATION:

COMPANY NAME:

START DATE:

VALID DAYS: M T W TH F SA SU

VALID TIMES:

EXPIRATION DATE:

Sponsor (DoD CAC Holder) Rank, Name, Unit/ORG:

Sponsor Contact Numbers (On-base & cell):

Sponsor E-Mail Address (.mil):

Date:Signature:

Text20:
Text21:
Text22:
Text23:
Text28:
Text25:
Text29:
Text30:
Text26:
Check Box3: Off
Check Box4: Off
Check Box5: Off
Check Box6: Off
Check Box7: Off
Check Box8: Off
Check Box9: Off
Text24:
Text1:
DL state 1:
0:
0:
0:
0:
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
11:
12:
13:
14:
15:
16:
17:
DL NUMBER 1:
0:
0:
0:
0:
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
11:
12:
13:
14:
15:
16:
17:
DOB 1:
0:
0:
0:
0:
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
11:
12:
13:
14:
15:
16:
17:
name 1:
0:
0:
0:
0:
0:
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
11:
12:
13:
14:
15:
16:
17:
SSAN 1:
0:
0:
0:
0:
0:
0:
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
11:
12:
13:
14:
15:
16:
17:

File details come from the government source that posted it. Updated .