Memorandum for 934 SFS_VISOTR Control.pdf
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DEPARTMENT OF THE AIR FORCE
AIR FORCE RESERVE COMMAND
PRIVACY ACT INFORMATION: THIS FORM IS SUBJECT TO THE PRIVACY ACT OF 1974
MEMORANDUM FOR 934 SFS/VISITOR CONTROL
FROM: Date:
SUBJECT: VISITOR REQUEST
1. is requesting the following individuals be granted access to Bldg for on , starting at hrs. and ending at hrs. All persons on this request have consented to a background check as a condition of entry. Negative results will result in a denial of entry. If more than eight (8) visitors, please use page two (2) of this form.
2. If any visitor(s) is not a US Citizen please call 612-713-1102 for further instructions. Vetting foreign nationals will take a minimum of 72 hours to process.
Office Use Only
3. The authorized sponsor is required to submit this completed and digitally signed form to the Visitor Control Center, Bldg. 906 in person or via encrypted email at 934SFS.VCC.VisitorRequest@us.af.mil at least three business days prior to the event/visit.
4. Once vetted, DBIDS passes will be issued to the visitor at Bldg 906 the day of the event. Visitors are restricted to transit to and from the location of the activity. By signing this form, the sponsor acknowledges they are responsible for the supervision of these visitors while they are on the installation.
5. If there are any questions or concerns, (Rank/name of the Sponsor) can be reached at (Email address), (work phone) or (cell phone).
Full Name (Last, First, Full Middle) DOB (mm/dd/0000)
DL Number (with dashes)
State US Citizen (Yes/No)
CHC CCW
mailto:934SFS.VCC.VisitorRequest@us.af.mil
Full Name (Last, First, Full Middle) DOB (mm/dd/0000)
DL Number (with dashes)
State US Citizen (Yes/No)
CHC CCW
| Full Name Last First Full Middle1: |
| DOB mmdd00001: |
| DL Number with dashes1: |
| State1: |
| US Citizen YesNo1: |
| CHC1: |
| CCW1: |
| Full Name Last First Full Middle2: |
| DOB mmdd00002: |
| DL Number with dashes2: |
| State2: |
| US Citizen YesNo2: |
| CHC2: |
| CCW2: |
| Full Name Last First Full Middle3: |
| DOB mmdd00003: |
| DL Number with dashes3: |
| State3: |
| US Citizen YesNo3: |
| CHC3: |
| CCW3: |
| Full Name Last First Full Middle4: |
| DOB mmdd00004: |
| DL Number with dashes4: |
| State4: |
| US Citizen YesNo4: |
| CHC4: |
| CCW4: |
| Full Name Last First Full Middle5: |
| DOB mmdd00005: |
| DL Number with dashes5: |
| State5: |
| US Citizen YesNo5: |
| CHC5: |
| CCW5: |
| Full Name Last First Full Middle6: |
| DOB mmdd00006: |
| DL Number with dashes6: |
| State6: |
| US Citizen YesNo6: |
| CHC6: |
| CCW6: |
| Full Name Last First Full Middle7: |
| DOB mmdd00007: |
| DL Number with dashes7: |
| State7: |
| US Citizen YesNo7: |
| CHC7: |
| CCW7: |
| Full Name Last First Full Middle8: |
| DOB mmdd00008: |
| DL Number with dashes8: |
| State8: |
| US Citizen YesNo8: |
| CHC8: |
| CCW8: |
| Full Name Last First Full MiddleRow1: |
| DOB mmdd0000Row1: |
| DL Number with dashesRow1: |
| StateRow1: |
| US Citizen YesNoRow1: |
| CHCRow1: |
| CCWRow1: |
| Full Name Last First Full MiddleRow2: |
| DOB mmdd0000Row2: |
| DL Number with dashesRow2: |
| StateRow2: |
| US Citizen YesNoRow2: |
| CHCRow2: |
| CCWRow2: |
| Full Name Last First Full MiddleRow3: |
| DOB mmdd0000Row3: |
| DL Number with dashesRow3: |
| StateRow3: |
| US Citizen YesNoRow3: |
| CHCRow3: |
| CCWRow3: |
| Full Name Last First Full MiddleRow4: |
| DOB mmdd0000Row4: |
| DL Number with dashesRow4: |
| StateRow4: |
| US Citizen YesNoRow4: |
| CHCRow4: |
| CCWRow4: |
| Full Name Last First Full MiddleRow5: |
| DOB mmdd0000Row5: |
| DL Number with dashesRow5: |
| StateRow5: |
| US Citizen YesNoRow5: |
| CHCRow5: |
| CCWRow5: |
| Full Name Last First Full MiddleRow6: |
| DOB mmdd0000Row6: |
| DL Number with dashesRow6: |
| StateRow6: |
| US Citizen YesNoRow6: |
| CHCRow6: |
| CCWRow6: |
| Full Name Last First Full MiddleRow7: |
| DOB mmdd0000Row7: |
| DL Number with dashesRow7: |
| StateRow7: |
| US Citizen YesNoRow7: |
| CHCRow7: |
| CCWRow7: |
| Full Name Last First Full MiddleRow8: |
| DOB mmdd0000Row8: |
| DL Number with dashesRow8: |
| StateRow8: |
| US Citizen YesNoRow8: |
| CHCRow8: |
| CCWRow8: |
| Full Name Last First Full MiddleRow9: |
| DOB mmdd0000Row9: |
| DL Number with dashesRow9: |
| StateRow9: |
| US Citizen YesNoRow9: |
| CHCRow9: |
| CCWRow9: |
| Full Name Last First Full MiddleRow10: |
| DOB mmdd0000Row10: |
| DL Number with dashesRow10: |
| StateRow10: |
| US Citizen YesNoRow10: |
| CHCRow10: |
| CCWRow10: |
| Full Name Last First Full MiddleRow11: |
| DOB mmdd0000Row11: |
| DL Number with dashesRow11: |
| StateRow11: |
| US Citizen YesNoRow11: |
| CHCRow11: |
| CCWRow11: |
| Full Name Last First Full MiddleRow12: |
| DOB mmdd0000Row12: |
| DL Number with dashesRow12: |
| StateRow12: |
| US Citizen YesNoRow12: |
| CHCRow12: |
| CCWRow12: |
| Full Name Last First Full MiddleRow13: |
| DOB mmdd0000Row13: |
| DL Number with dashesRow13: |
| StateRow13: |
| US Citizen YesNoRow13: |
| CHCRow13: |
| CCWRow13: |
| Full Name Last First Full MiddleRow14: |
| DOB mmdd0000Row14: |
| DL Number with dashesRow14: |
| StateRow14: |
| US Citizen YesNoRow14: |
| CHCRow14: |
| CCWRow14: |
| Full Name Last First Full MiddleRow15: |
| DOB mmdd0000Row15: |
| DL Number with dashesRow15: |
| StateRow15: |
| US Citizen YesNoRow15: |
| CHCRow15: |
| CCWRow15: |
| Full Name Last First Full MiddleRow16: |
| DOB mmdd0000Row16: |
| DL Number with dashesRow16: |
| StateRow16: |
| US Citizen YesNoRow16: |
| CHCRow16: |
| CCWRow16: |
| Full Name Last First Full MiddleRow17: |
| DOB mmdd0000Row17: |
| DL Number with dashesRow17: |
| StateRow17: |
| US Citizen YesNoRow17: |
| CHCRow17: |
| CCWRow17: |
| Full Name Last First Full MiddleRow18: |
| DOB mmdd0000Row18: |
| DL Number with dashesRow18: |
| StateRow18: |
| US Citizen YesNoRow18: |
| CHCRow18: |
| CCWRow18: |
| Full Name Last First Full MiddleRow19: |
| DOB mmdd0000Row19: |
| DL Number with dashesRow19: |
| StateRow19: |
| US Citizen YesNoRow19: |
| CHCRow19: |
| CCWRow19: |
| Full Name Last First Full MiddleRow20: |
| DOB mmdd0000Row20: |
| DL Number with dashesRow20: |
| StateRow20: |
| US Citizen YesNoRow20: |
| CHCRow20: |
| CCWRow20: |
| Full Name Last First Full MiddleRow21: |
| DOB mmdd0000Row21: |
| DL Number with dashesRow21: |
| StateRow21: |
| US Citizen YesNoRow21: |
| CHCRow21: |
| CCWRow21: |
| Full Name Last First Full MiddleRow22: |
| DOB mmdd0000Row22: |
| DL Number with dashesRow22: |
| StateRow22: |
| US Citizen YesNoRow22: |
| CHCRow22: |
| CCWRow22: |
| Full Name Last First Full MiddleRow23: |
| DOB mmdd0000Row23: |
| DL Number with dashesRow23: |
| StateRow23: |
| US Citizen YesNoRow23: |
| CHCRow23: |
| CCWRow23: |
| Full Name Last First Full MiddleRow24: |
| DOB mmdd0000Row24: |
| DL Number with dashesRow24: |
| StateRow24: |
| US Citizen YesNoRow24: |
| CHCRow24: |
| CCWRow24: |
| Full Name Last First Full MiddleRow25: |
| DOB mmdd0000Row25: |
| DL Number with dashesRow25: |
| StateRow25: |
| US Citizen YesNoRow25: |
| CHCRow25: |
| CCWRow25: |
| Full Name Last First Full MiddleRow26: |
| DOB mmdd0000Row26: |
| DL Number with dashesRow26: |
| StateRow26: |
| US Citizen YesNoRow26: |
| CHCRow26: |
| CCWRow26: |
| Full Name Last First Full MiddleRow27: |
| DOB mmdd0000Row27: |
| DL Number with dashesRow27: |
| StateRow27: |
| US Citizen YesNoRow27: |
| CHCRow27: |
| CCWRow27: |
| Full Name Last First Full MiddleRow28: |
| DOB mmdd0000Row28: |
| DL Number with dashesRow28: |
| StateRow28: |
| US Citizen YesNoRow28: |
| CHCRow28: |
| CCWRow28: |
| Full Name Last First Full MiddleRow29: |
| DOB mmdd0000Row29: |
| DL Number with dashesRow29: |
| StateRow29: |
| US Citizen YesNoRow29: |
| CHCRow29: |
| CCWRow29: |
| Full Name Last First Full MiddleRow30: |
| DOB mmdd0000Row30: |
| DL Number with dashesRow30: |
| StateRow30: |
| US Citizen YesNoRow30: |
| CHCRow30: |
| CCWRow30: |
| Full Name Last First Full MiddleRow31: |
| DOB mmdd0000Row31: |
| DL Number with dashesRow31: |
| StateRow31: |
| US Citizen YesNoRow31: |
| CHCRow31: |
| CCWRow31: |
| Full Name Last First Full MiddleRow32: |
| DOB mmdd0000Row32: |
| DL Number with dashesRow32: |
| StateRow32: |
| US Citizen YesNoRow32: |
| CHCRow32: |
| CCWRow32: |
| Full Name Last First Full MiddleRow33: |
| DOB mmdd0000Row33: |
| DL Number with dashesRow33: |
| StateRow33: |
| US Citizen YesNoRow33: |
| CHCRow33: |
| CCWRow33: |
| Full Name Last First Full MiddleRow34: |
| DOB mmdd0000Row34: |
| DL Number with dashesRow34: |
| StateRow34: |
| US Citizen YesNoRow34: |
| CHCRow34: |
| CCWRow34: |
| Full Name Last First Full MiddleRow35: |
| DOB mmdd0000Row35: |
| DL Number with dashesRow35: |
| StateRow35: |
| US Citizen YesNoRow35: |
| CHCRow35: |
| CCWRow35: |
| Full Name Last First Full MiddleRow36: |
| DOB mmdd0000Row36: |
| DL Number with dashesRow36: |
| StateRow36: |
| US Citizen YesNoRow36: |
| CHCRow36: |
| CCWRow36: |
| Full Name Last First Full MiddleRow37: |
| DOB mmdd0000Row37: |
| DL Number with dashesRow37: |
| StateRow37: |
| US Citizen YesNoRow37: |
| CHCRow37: |
| CCWRow37: |
| Full Name Last First Full MiddleRow38: |
| DOB mmdd0000Row38: |
| DL Number with dashesRow38: |
| StateRow38: |
| US Citizen YesNoRow38: |
| CHCRow38: |
| CCWRow38: |
| Full Name Last First Full MiddleRow39: |
| DOB mmdd0000Row39: |
| DL Number with dashesRow39: |
| StateRow39: |
| US Citizen YesNoRow39: |
| CHCRow39: |
| CCWRow39: |
| Text71: NAME |
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| Text73: NAME |
| Text74: PROJECT |
| Text75: DATE |
| Text76: START |
| Text77: END |
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File details come from the government source that posted it. Updated .