5._FA8522-13-R-00139_RFP_Atch_DD2875_SAAR_Instructions_for_DD_Form_2875_CAV_II.pdf

DD Form 2875, System Authorization Access Request (SAAR) Instructions.

Version 1 09 November 2012

Note: Completion of all blocks is mandatory on the DD Form 2875 unless otherwise noted:

Header

Select Type of Request

Input Date, use YYYYMMDD format

Input System Name: CAV AF

Leave Location Block blank

Part I Blocks

1 – 9 Must be filled out with user information

10 Information Assurance (IA) Awareness Training Requirements – box must be checked for all ICP users and the date entered must be within one year of this access request. (Not applicable for contractor users)

Part II Blocks

11 – 12 Sign and Date

Justification input “To Access CAV AF System”, plus User Type and ICP DODAAC

{FD2060(WRALC), .

Enter one of the following for User Type:

Contractor (Without GFM Options) Contractor (With GFM Options) Contractor (View Only, without GFM Options) – no reporting ability Contractor (View Only Repair & GFM Reports) – no reporting ability ICP (View Only)- Government only for PMS/IMS ICP (Manage By Contract) – Government only For CM ADMIN (Manage By Contract) – Government only For SA

14 Check “Authorized”.

15 Check “Unclassified”.

16 Check box.

16a Contractors must fill with; Company Name, Contract Number, Expiration Date, DODAAC (EZXXXX) – use block 27 if necessary. Please list every DoDAAC you require access to.

17 - 20b These must be completed by their Supervisor.

21 - 21b Will be completed in full by ICP System Administrator.

26 Same as Block 1.

DD Form 2875, System Authorization Access Request (SAAR) Instructions.

Version 1 09 November 2012

27 May be blank but can be used to continue 16a.

Part III

For Repair Suppliers:

Please enter required PKI information

28- Enter: “PKI certification through: Verisign, Identrust, ORC or DoD (choose one)”

28a- Enter date of investigation

28b- Leave blank

Level II: Read / Write type access normally for government contract monitors/ and contractors

Level III: Read only access for view only access

29-32 Leave blank

For Government personnel:

28- Please submit to your security manager to verify and complete

Level I: For Administrator / System Owner Level

Level II: Read / Write type access normally for government contract monitors/ and contractors

Level III: Read only access for view only access

29-32 Leave blank

Part IV Leave blank

Scan and Email DD Form 2875 to 406scms.cav.af.ar@robins.af.mil

Any questions, please call 478-327-6602 or 478-327-6603 mailto:406scms.cav.af.ar@robins.af.mil