FORM 301.pdf

PDF 881 KB Posted

Attached to
INDUSTRY DAY SITE VISIT on 14 and 15 May 2025 for the Above Ground Construction Services Contract (CSC) pre solicitation
Solicitation number
HDTRA225RE0010004
Issued by

About this file

Written by GovTribe AI ·

The document is a White Sands Missile Range Access Badge (WAB Badge)/Up-Range Request Form for accessing the missile range. The form is prescribed by Army Regulation 190-13 and WSMR Visitor Control Policy 2024, issued by the Directorate of Emergency Services-Physical Security. The specific purpose of this request is for CPTC construction, with the sponsoring organization being DTRA (Defense Threat Reduction Agency). The form requires detailed personal information for criminal history record checks, and sponsors must ensure personnel receive a UXO (Unexploded Ordnance) Briefing before requesting Up-Range access. The form covers a potential access period from 24AUG2024 to 26AUG2024, and must be submitted to the provided Army email address for physical security approval.

View the file

Other files

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

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file
Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

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.

Last NameRow1:
First NameRow1:
Middle Name or NA if noneRow1:
OrganizationRow1:
Last NameRow2:
First NameRow2:
Middle Name or NA if noneRow2:
OrganizationRow2:
Last NameRow3:
First NameRow3:
Middle Name or NA if noneRow3:
OrganizationRow3:
Last NameRow4:
First NameRow4:
Middle Name or NA if noneRow4:
OrganizationRow4:
Last NameRow5:
First NameRow5:
Middle Name or NA if noneRow5:
OrganizationRow5:
Last NameRow6:
First NameRow6:
Middle Name or NA if noneRow6:
OrganizationRow6:
Last NameRow7:
First NameRow7:
Middle Name or NA if noneRow7:
OrganizationRow7:
Last NameRow8:
First NameRow8:
Middle Name or NA if noneRow8:
OrganizationRow8:
Last NameRow9:
First NameRow9:
Middle Name or NA if noneRow9:
OrganizationRow9:
Last NameRow10:
First NameRow10:
Middle Name or NA if noneRow10:
OrganizationRow10:
Last NameRow11:
First NameRow11:
Middle Name or NA if noneRow11:
OrganizationRow11:
Last NameRow12:
First NameRow12:
Middle Name or NA if noneRow12:
OrganizationRow12:
Last NameRow13:
First NameRow13:
Middle Name or NA if noneRow13:
OrganizationRow13:
Purpose for Visit: CPTC construction
Dropdown2:
0: [ ]
1: [ ]
2: [ ]
3: [ ]
4: [ ]
5: [ ]
6: [ ]
7: [ ]
8: [ ]
9: [ ]
10: [ ]
11: [ ]
12: [ ]
Dropdown4:
0: [ ]
1: [ ]
2: [ ]
3: [ ]
4: [ ]
5: [ ]
6: [ ]
7: [ ]
8: [ ]
9: [ ]
10: [ ]
11: [ ]
12: [ ]
Date5_af_date:
0:
0:
1:
1:
0:
1:
2:
0:
1:
3:
0:
1:
4:
0:
1:
5:
0:
1:
6:
0:
1:
7:
0:
1:
8:
0:
1:
9:
0:
1:
10:
0:
1:
11:
0:
1:
12:
0:
1:
Text7: LT Elisabeth C McClung
Text8: DTRA
Text9: 505-353-4040
Text10: elisabeth.c.mcclung.mil@mail.mil
Date12_af_date:
Date15_af_date:

File details come from the government source that posted it. Updated .