38_NTTR Automated Information System _AIS_ Equipment Form.pdf

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SABER IDIQ
Solicitation number
FA486125R0003
Issued by

About this file

This document is a Nevada Test and Training Range (NTTR) Automated Information Systems (AIS) Equipment Briefing and Acknowledgement form for personnel seeking to bring camera or video equipment onto the military range. The form outlines strict guidelines for photography, including that all equipment must be mission-related and require prior justification and approval. Key requirements include:

Photographers must obtain a NTTR camera permit from the Security Office, with contact information at Nellis AFB. All photographs are subject to review and approval by the NTTR Program Security Office before release. Only material specifically approved by NTTR can be photographed, and no pictures of classified or sensitive material are permitted without custodian approval. Temporary camera permits will be returned to Security personnel at the Entry Control point, and the equipment pass can be revoked at any time by authorized NTTR personnel. The form requires detailed information about the photographer, including name, organization, clearance level, and specific location of work within the range.

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Text version

NEVADA TEST AND TRAINING RANGE (NTTR)

File 22d

AUTOMATED INFORMATION SYSTEMS (AIS) EQUIPMENT BRIEFING AND ACKNOWLEDGEMENT

I. Name: __________________________________________ SSN (LAST 4) _________ Start Date:

(Last) (First) (Middle Initial) Unit/Sq/Company: _____________________ End Date:

Location of Work: ______________________________________

Duties Requiring Permit: _________________________________________________________________________________________

Lisa.Coker Typewritten Text

Lisa.Coker Text Box "L"

Lisa.Coker Typewritten Text IE: Southern Range (14) / Tolicha Peak (15) / TTR (17)

Lisa.Coker Typewritten Text COMPLETED FORMS MUST BE FORWARDED TO THE NTTR SECURITY OFFICE, A MINIMUM OF 5 WORKING DAYS PRIOR TO THE START OF VISIT

Lisa.Coker Typewritten Text

Lisa.Coker Text Box Clearance Level:

Lisa.Coker Typewritten Text Not to exceed one year

Lisa.Coker Rectangle

Lisa.Coker Rectangle

Lisa.Coker Rectangle

Lisa.Coker Text Box "Q"

Lisa.Coker Text Box Top Secret

Lisa.Coker Text Box Secret

Lisa.Coker Rectangle

Lisa.Coker Line

Lisa.Coker Typewritten Text (Pass holder must hold a current security clearance)

Lisa.Coker Line

Lisa.Coker Text Box Camera Permit

Lisa.Coker Line

Lisa.Coker Text Box

III

Lisa.Coker Text Box

Lisa.Coker Text Box AIS Equipment / All Other Equipment / Additional Item Equipment

Lisa.Coker Line

Lisa.Coker Line

Lisa.Coker Line

Lisa.Coker Text Box All equipment brought on the Range will be mission related and will require justification prior to approval. All persons using a camera, video or still on the Ranges of the Nevada Test and Training Range, must possess a NTTR Camera Permit authorized and issued by the NTTR Security Office (Nellis AFB, Bldg 200, DSN 348-4606, Comm 702-653-4606). The camera holder must brief Black Jack (DSN 348-4705/4707, Comm 702-653-4705/4707) daily. This brief will include the WHO, WHERE, WHEN, AND WHY specific photographs are being taken. NO photographs will be taken without the daily approval from Black Jack. This includes personnel flying into Range air space.

1. The photographer will take pictures of only material specifically approved by the NTTR and will avoid taking pictures that include any other range facilities or equipment.

2. Photographers taking pictures of any classified or sensitive material must have the approval of the custodian and/or the approval of the head of the organization responsible for the material. When the classification or sensitivity of material being photographed is in doubt, it is the responsibility of the photographer to obtain approval from the custodian/owner of the material.

3. The photographer and all personnel, who will have access to the photographs, film, negatives, etc., must be cleared to at least the level of photographed material.

4. All photographs taken will be reviewed and approved by the NTTR Program Security Office and/or other designated NTTR staff prior to being released.

5. Temporary Camera permits will be returned to Security personnel at the Entry Control point upon completion of photographing activities.

6. Only the individual who has been issued a camera permit and have signed this briefing and acknowledgement, are authorized to use approved photographic/video equipment.

7. The equipment pass can be revoked at any time by authorized NTTR personnel.

Lisa.Coker Line

Lisa.Coker Text Box IV Permit User's Signature: Date:

Lisa.Coker Line

Lisa.Coker Line

Lisa.Coker Line

Lisa.Coker Line

Lisa.Coker Line

Lisa.Coker Text Box

OFFICE USE ONLY

Lisa.Coker Text Box Authorizing Official:

Lisa.Coker Text Box Officials Signature:

Lisa.Coker Text Box Date:

Lisa.Coker Text Box Permit Number:

Lisa.Coker Text Box

Lisa.Coker Text Box I Name: ____________________________________ SSN (LAST 4): _________ Start Date: ____________ End Date: ____________ (Last) (First) (Middle Initial) (not to exceed one year)

Location of Work: _____________________________________ Duties Requiring Permit: ______________________________________________ IE: Southern Range (14) / Tolicha Peak (15) / TTR (17)

Lisa.Coker Text Box Camera /Video

Lisa.Coker Text Box Computer W/O Built in Camera

Lisa.Coker Text Box Model and Serial Number

Lisa.Coker Text Box Type of Equipment, Model and Serial Number (Attach Additional Pages as Needed)

Lisa.Coker Text Box

II

Lisa.Coker Text Box Optic # Provided By Authorizing Office:

Lisa.Coker Typewritten Text

Lisa.Coker Typewritten Text

Lisa.Coker Typewritten Text Org/Company:

Lisa.Coker Typewritten Text Duty or Contact Phone #:

OPTICS NUMBER:
Last Name:
First Name:
Middle Initial:
SSAN (Last 4):
Start Date:
End Date:
Location of Work:
Duties Requiring Permit:
Org/Company:
Phone:
Q: Off
L: Off
TS: Yes
S: Off
Camera/Video:
Computer W/O Built in Camera:
AIS Equipment/All Other/Additional:
Date Signed:
Auth Official:
Date Approved:
Permit Number:

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