DLA_Form_1818.pdf
DLA Form PDF 101 KB Posted
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- AFICA IAC CS TATs
- Solicitation number
- FA8075-14-R-0001
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Text version
PRIVACY ACT STATEMENT
VISIT NOTIFICATION
1. ACTIVITY TO BE VISITED
AUTHORITY:
PRINCIPAL PURPOSE:
ROUTINE USES:
DISCLOSURE:DEFENSE LOGISTICS AGENCY
8725 JOHN J. KINGMAN ROAD
FT BELVOIR, VA 22060-6220
Section 21, 50 U.S.C. 781 et seq.; Executive Order 10450.
To control access to and movement on DoD installations, buildings, or facilities.
Used by General Services Administration Protective Service Personnel for access control and for any of the Blanket Routine Uses published by DLA.
Voluntary. However, failure to provide all the requested information may result in refusal to grant access to the installation, building, or facility.
DLA PRIVACY ACT SYSTEM NOTICE S500.50 DLA-I APPLIES
SECTION I
2. NAME OF REQUESTOR/PREPARER 4. TELEPHONE3. OFFICE CODE
5. DATE(S) OF VISIT 6. POINT OF CONTACT (at facility to be visited) 7. POC TELEPHONE
8. PURPOSE OF VISIT
SECTION II
9.
NAME(S) OF VISITOR(S)
(Last, First, MI)
10.
GRADE/RANK
11.
SSN
12.
DATE OF BIRTH
13.
STATE /COUNTRY OF
BIRTH
14.
CLEARANCE/DATE
GRANTED
15.
TYPE OF INVESTIGATION/
DATE
16. TYPED NAME OF SECURITY REPRESENTATIVE
SECTION III
18. ACTIVITY 19. TELEPHONE NUMBER 20. DATE17. SIGNATURE OF SECURITY REPRESENTATIVE
DLA FORM 1818, JUL 96 (EG)
FROM: TO:
PDF (DLA)
| RequesterName: |
| OfficeCode: IAC |
| FacPOC: Daniel Peat or Melinda Rozga |
| Phone: |
| POCPhone: (703) 767 -9112/9122 |
| VisitedActivity: Defense Logistics Agency Headquarters Auditorium (Andrew T. McNamara Complex) for the Defense Technical Information Center Information Analysis Center (DTIC IAC) organization sponsored event. |
| VisitPurpose: To attend the Information Analysis Center (IAC) Cyber Security Technical Area Tasks (CS TATs) $2.4B acquisition "Industry Day" being held in the Defense Logistics Agency Headquarters Auditorium (Andrew T. McNamara Complex) |
| DateTo: 27 May 2014 |
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