CS_050515_eform.pdf

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Enterprise Architecture (EACOE) Quick Start
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HB0001-18-R-0003
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UNCLASSIFIED//FOR OFFICIAL USE ONLY

CON

CON Form, Revised February 2015

UNCLASSIFIED//FOR OFFICIAL USE ONLY

MMiilliittaarryy CCoonnttiinnuuaattiioonn SShheeeett

Please use this space to explain any affirmative answers and/or additional foreign travel from the Military Security In-Processing (SIP) Form or any explanations needed from the Military Additional Contact Sheet (ACS). Before each answer, identify the form and question number (if applicable), and try to maintain the question format.

Your Last Name: SSN (last four) Date (MM/DD/YY): / / Initials: _________

Security Office Only: Reviewed by (SSO) Date (MM/DD/YY): / /

Your Last Name:
SSN last four:
Date MMDDYY:
undefined:
undefined_2:
Initials:
Date MMDDYY_2:
undefined_3:
undefined_4:
Text1:
PAS: PRIVACY ACT STATEMENT: Authority for collecting the requested information is contained in 50 U.S.C. § 401-441, Executive Order 10450, Executive Order 13526, Executive Order 12968, and ICD 704. DoD's Blanket Routine Uses (found at Appendix C of 32 CFR Part 310) apply to this information. Authority for requesting your Social Security Number (SSN) is Executive Order 9397, as amended. The requested information you provide will be used to confirm your identity in order to verify clearances and access. Your disclosure of the requested information is voluntary. However, failure to furnish the requested information may delay or prevent the processing of your access request.

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