Foreign National Security Form.pdf

Feb 2019 Version

Nashville District Corps of Engineers Foreign National Site Visit Request Form

Foreign Nationals (FNs): All non-U.S. Citizens, including permanent residents wishing to request a site visit at a

Nashville District (LRN) project must be approved 30 days in advance. FNs requesting a site visit ( includes: pre-bid meeting) must complete a LRN FN Pre-Bid Meeting Request Form and submit any two (2) legible color copies of the following documents: Passport (unexpired or expired), Certificate of U.S. Citizenship (INS Form N-560 04 N-561), Certificate of Naturalization (INS Form N-550 or N-570), unexpired foreign Passport with I-551 stamp or attached INS

Form I-94 indicating unexpired employment authorization, an Alien Registration Receipt Card with photo (INS Form I-

151 or I-551), unexpired Temporary Resident Card (INS Form I-688), unexpired Employment Authorization Card (INS

Form I-688A), unexpired Reentry Permit (INS Form I-327), unexpired Refugee Travel Document (INS- Form I-571), or unexpired INS issued Employment Authorization Documentation that contains a photograph (INS Form I-688B).

Documents must not expire on or before visit. Submit requests to your LRN pre-bid/meeting POC, they will forwarded it to LRN Security Management Office (SM) mailbox (dll-celrn-sm@usace.army.mil) for approval. All documents must be received 30 days in advance of the site visit of pre-bid meeting. FN requests require approval from Headquarters U.S.

Army Corps of Engineers (HQUSACE). Exceptions will be considered on a case by case basis but will be limited.

Date of submission to LRN POC (mm/dd/yyyy) _______________________

Name of Site _______________________________ LRN Site POC _____________________________

Requestors FULL Name ______________________________________________________________

(Last, First Middle) If you have only initials in your name, use them and state (IO). If you have no middle name, enter “NMN” If you are a “Jr.,”Sr.,” “II,” etc., this must be indicated

Date of Birth (mm/dd/yyyy) _______________ Citizenship (Country) _________________________

Place of Birth (City/Town/Providence/County etc.) _________________________________________

Date(s) of Requested Site Visit (mm/dd/yyyy) ____________________________

Passport # (Include a scanned color copy) _________________________________________

VISA # (Include a scanned color copy) _____________________________________________ *Unless the country of citizenship participates in the VISA Waiver Program (VWP).

Nashville District Corps of Engineers Security Office Contact Information:

Tracy Dorrough, Personnel Security Specialist, 615-736-7397 email: tracy.dorrough@usace.army.mil John Carter, Security Specialist, 615-736-5567 email: john.j.carter@usace.army.mil Jay Klinger, Chief of Security, 615-736-2185 email: jason.j.klinger@usace.army.mil Fax Number: 615-736-7145

Mailing Address: USACE, Nashville

110 9th Ave S, Room A-450

ATTN: CELRN-SM

Nashville, TN 37203

PRIVACY ACT STATEMENT

AUTHORITY: Information is solicited pursuant to Title 10, U.S. Code, Section 3013 and E.O. 9397.

PRINCIPAL PURPOSE: To provide information necessary for preparation of a scheduled visit of the facility, verify positive identification of visitor(s), and conduct background checks for determinations of the eligibility of individuals for access to U.S. Army Corps of Engineers facilities.

ROUTINE USES: Used by the U.S. Army Corps of Engineers to accompany a request for a scheduled tour of the facility.

MANDATORY OR VOLUNTARY DISCLOSURE AND EFFECT OF NOT PROVIDING INFORMATION: Providing the solicited information, including Social Security Number, is voluntary; however, failure to provide information may result in a denial of visitor access due to an inability to verify identification. The information provided to the U.S. Army Corps of Engineers will not be retained digitally or by hard copy after the scheduled visit.

https://www.cbp.gov/travel/international-visitors/visa-waiver-program mailto:tracy.dorrough@usace.army.mil mailto:john.j.carter@usace.army.mil mailto:jason.j.klinger@usace.army.mil