JBER_Access_Request_Form_Blank.xlsx
XLSX spreadsheet 93 KB Posted
- Solicitation number
- FA5215-18-R-9004
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Base Access Request Form
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NEW ADDITIONS
673 SFS ONLY NEW ADDITIONS
| 1) Type dates and phone numbers without spaces, dashes or slashes. EXAMPLE: 6jun1990 or 9072224440; it will automatically format. | |||||||||||||||||||||||||
| 2) Non-U.S. citizens MUST be identified and a copy of their E-Verify letter must accompany the request list. | |||||||||||||||||||||||||
| 3) DO NOT include currently approved individuals in "NEW ADDITIONS"; they go in the "UPDATES" Tab. | |||||||||||||||||||||||||
| Last Name | First Name | Middle Name | Sex | Date of Birth | DL or ID # | State of Issue | U.S. Citizen | Passport # | Company Name | Sponsoring Organization (To be conpleted by Sponsoring Unit POC ONLY) | Access Dates | Days of Access | Access Hours | Escort | |||||||||||
| Organization Name | Point of Contact | DoD ID # | Phone # | Start | End | Su | Mo | Tu | We | Th | Fr | Sa | Start | End |
| DENIED | ||||||
| F | AK | Yes | X | 0000 | Y | |
| M | AL | No | 0030 | N | ||
| U | AR | 0100 | ||||
| AZ | 0130 | |||||
| CA | 0200 | |||||
| CO | 0230 | |||||
| CT | 0300 | |||||
| DE | 0330 | |||||
| FL | 0400 | |||||
| GA | 0430 | |||||
| HI | 0500 | |||||
| IA | 0530 | |||||
| ID | 0600 | |||||
| IL | 0630 | |||||
| IN | 0700 | |||||
| KS | 0730 | |||||
| KY | 0800 | |||||
| LA | 0830 | |||||
| MA | 0900 | |||||
| MD | 0930 | |||||
| ME | 1000 | |||||
| MI | 1030 | |||||
| MN | 1100 | |||||
| MO | 1130 | |||||
| MS | 1200 | |||||
| MT | 1300 | |||||
| NC | 1330 | |||||
| ND | 1400 | |||||
| NE | 1430 | |||||
| NH | 1500 | |||||
| NJ | 1530 | |||||
| NM | 1600 | |||||
| NY | 1630 | |||||
| OH | 1700 | |||||
| OK | 1730 | |||||
| OR | 1800 | |||||
| PA | 1830 | |||||
| RI | 1900 | |||||
| SC | 1930 | |||||
| SD | 2000 | |||||
| TN | 2030 | |||||
| TX | 2100 | |||||
| UT | 2130 | |||||
| VA | 2200 | |||||
| VT | 2230 | |||||
| WA | 2300 | |||||
| WI | 2330 | |||||
| WV | 2359 | |||||
| WY | ||||||
| AS | ||||||
| DC | ||||||
| FM | ||||||
| GU | ||||||
| MH | ||||||
| MP | ||||||
| PW | ||||||
| PR | ||||||
| VI |
UPDATES & CORRECTIONS
673 SFS ONLY UPDATES/CORRECTIONS
| 1) Type dates and phone numbers without spaces, dashes or slashes. EXAMPLE: 6jun1990 or 9072224440; it will automatically format. | |||||||||||||||||||||||||
| 2) Non-U.S. citizens MUST be identified and a copy of their E-Verify letter must accompany the request list. | |||||||||||||||||||||||||
| 3) DO NOT include NEW individuals in this tab; they go in the "NEW ADDITIONS" Tab. | |||||||||||||||||||||||||
| Last Name | First Name | Middle Name | Sex | Date of Birth | DL or ID # | State of Issue | U.S. Citizen | Passport # | Company Name | Sponsoring Organization (To be conpleted by Sponsoring Unit POC ONLY) | Start Date | End Date | Days of Access | Access Hours | Escort | ||||||||||
| Organization Name | Point of Contact | DoD ID # | Phone # | Su | Mo | Tu | We | Th | Fr | Sa | Start | End |
| DENIED | ||||||
| F | AK | Yes | X | 0000 | Y | |
| M | AL | No | 0030 | N | ||
| U | AR | 0100 | ||||
| AZ | 0130 | |||||
| CA | 0200 | |||||
| CO | 0230 | |||||
| CT | 0300 | |||||
| DE | 0330 | |||||
| FL | 0400 | |||||
| GA | 0430 | |||||
| HI | 0500 | |||||
| IA | 0530 | |||||
| ID | 0600 | |||||
| IL | 0630 | |||||
| IN | 0700 | |||||
| KS | 0730 | |||||
| KY | 0800 | |||||
| LA | 0830 | |||||
| MA | 0900 | |||||
| MD | 0930 | |||||
| ME | 1000 | |||||
| MI | 1030 | |||||
| MN | 1100 | |||||
| MO | 1130 | |||||
| MS | 1200 | |||||
| MT | 1300 | |||||
| NC | 1330 | |||||
| ND | 1400 | |||||
| NE | 1430 | |||||
| NH | 1500 | |||||
| NJ | 1530 | |||||
| NM | 1600 | |||||
| NY | 1630 | |||||
| OH | 1700 | |||||
| OK | 1730 | |||||
| OR | 1800 | |||||
| PA | 1830 | |||||
| RI | 1900 | |||||
| SC | 1930 | |||||
| SD | 2000 | |||||
| TN | 2030 | |||||
| TX | 2100 | |||||
| UT | 2130 | |||||
| VA | 2200 | |||||
| VT | 2230 | |||||
| WA | 2300 | |||||
| WI | 2330 | |||||
| WV | 2359 | |||||
| WY | ||||||
| AS | ||||||
| DC | ||||||
| FM | ||||||
| GU | ||||||
| MH | ||||||
| MP | ||||||
| PW | ||||||
| PR | ||||||
| VI |
DELETIONS & REMOVALS
673 SFS ONLY DELETIONS /REMOVALS
| 1) Type dates and phone numbers without spaces, dashes or slashes. | |||||||||||||
| EXAMPLE: 6jun1990 or 9072224440; it will automatically format. | |||||||||||||
| Last Name | First Name | Middle Name | Sex | Date of Birth | DL or ID # | State of Issue | U.S. Citizen | Passport # | Company Name | Sponsoring Organization (To be conpleted by Sponsoring Unit POC ONLY) | |||
| Organization Name | Point of Contact | DoD ID # | Phone # |
| DENIED | |||||
| F | AK | Yes | 0000 | Y | |
| M | AL | No | 0030 | N | |
| AR | 0100 | ||||
| AZ | 0130 | ||||
| CA | 0200 | ||||
| CO | 0230 | ||||
| CT | 0300 | ||||
| DE | 0330 | ||||
| FL | 0400 | ||||
| GA | 0430 | ||||
| HI | 0500 | ||||
| IA | 0530 | ||||
| ID | 0600 | ||||
| IL | 0630 | ||||
| IN | 0700 | ||||
| KS | 0730 | ||||
| KY | 0800 | ||||
| LA | 0830 | ||||
| MA | 0900 | ||||
| MD | 0930 | ||||
| ME | 1000 | ||||
| MI | 1030 | ||||
| MN | 1100 | ||||
| MO | 1130 | ||||
| MS | 1200 | ||||
| MT | 1300 | ||||
| NC | 1330 | ||||
| ND | 1400 | ||||
| NE | 1430 | ||||
| NH | 1500 | ||||
| NJ | 1530 | ||||
| NM | 1600 | ||||
| NY | 1630 | ||||
| OH | 1700 | ||||
| OK | 1730 | ||||
| OR | 1800 | ||||
| PA | 1830 | ||||
| RI | 1900 | ||||
| SC | 1930 | ||||
| SD | 2000 | ||||
| TN | 2030 | ||||
| TX | 2100 | ||||
| UT | 2130 | ||||
| VA | 2200 | ||||
| VT | 2230 | ||||
| WA | 2300 | ||||
| WI | 2330 | ||||
| WV | 2359 | ||||
| WY | |||||
| AS | |||||
| DC | |||||
| FM | |||||
| GU | |||||
| MH | |||||
| MP | |||||
| PW | |||||
| PR | |||||
| VI |
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