FORM 301.pdf

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Attached to
INDUSTRY DAY SITE VISIT on 14 and 15 May 2025 for the Above Ground Construction Services Contract (CSC) pre solicitation
Solicitation number
HDTRA225RE001
Issued by

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The document is a White Sands Missile Range Access Badge (WAB Badge)/Up-Range Request Form for obtaining site access. The form is prescribed under Army Regulation 190-13 and WSMR Visitor Control Policy 2024, with the purpose of determining individual suitability for access to White Sands Missile Range through criminal history record checks. The specific request is for CPTC construction, sponsored by LT Elisabeth C McClung from DTRA (Defense Threat Reduction Agency), with a proposed access period from 24AUG2024 to 26AUG2024. The form requires detailed personal information and is to be submitted to usarmy.wsmr.imcom.mbx.physical-sec@army.mil, with a note that all personnel must receive a UXO (Unexploded Ordnance) Briefing before requesting Up-Range access.

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File Type Posted
NEW FORM 300.pdf PDF
Amend 0001 Industry Day Overview and Access on 14MAY 2025.pdf PDF
Visitor_Prenotification_Form.pdf PDF
Amend 0001 HDTRA225RE001 RFP 23APR2025.pdf PDF

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White Sands Missile Range Access Badge (WAB Badge)/Up-Range Request Form

PRESCRIBING REGULATION: ARMY REGULATION 190-13; WSMR VISITOR CONTROL POLICY 2024

PROPONENT: DIRECTORATE OF EMERGENCY SERVICES-PHYSICAL SECURITY

Privacy Act Statement

AUTHORITY: 10 U.S.C. 3013; 44 U.S.C. 3103; Army Regulation 190-13, Army Physical Security Program; and WSMR Visitor Control Policy 2024.

PRINCIPAL PURPOSE: To determine suitability of individual(s) requesting access to White Sands Missile Range. This information will be sued to generate state and federal criminal history record checks.

ROUTINE USE(S): Personal information may be disclosed to appropriate military and civilian emergency and investigation agencies to assist in determining suitability for access to White Sands Missile Range.

DISCLOSURE: Voluntary. However, failure to provide information could result in the refusal to access White Sands Missile Range.

Legal Name as Appears on Driver’s License of State ID.

Example: John Robert Doe

Yes DES Yes 24AUG2024 26AUG2024

Last Name First Name Middle Name or NA if none

CAC Card Yes/No

Organization Up Range Yes/No

Begin Date End Date

Purpose for Visit

Sponsor or Requester Information

Name of Sponsoring/Requesting Official: Name of Sponsor Organization:

Sponsor’s Phone Number: Sponsor’s Email: Date of Request:

(DES USE ONLY) Physical Security Approval: Approval Date:

When complete submit to: usarmy.wsmr.imcom.mbx.physical-sec@army.mil

WSMR FORM 301 JULY 2024

*Sponsoring organizations must ensure that all personnel will have UXO Briefing before requesting Up-Range access.

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Purpose for Visit: CPTC construction
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Text7: LT Elisabeth C McClung
Text8: DTRA
Text9: 505-353-4040
Text10: elisabeth.c.mcclung.mil@mail.mil
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