NAVFAC_WASH_PWD_SP_IH_Visit_Request.docx

EXPECTED VISITOR(S)

Email this sheet to either: DAHLGREN: PassID.NSASP-DLGR.fcm@navy.mil OR INDIAN HEAD: PassID.NSASP-INHD.fcm@navy.mil

ALL REQUESTS MUST BE SUBMITTED AT LEAST 5 WORKING DAYS PRIOR TO VISIT

CONTRACT#N40080-18-R-3519/ ENERGY REPAIRS MULT BLDGS NSF IH

MUST fill out the Vetting Form

NSASP 5512-17P

Date(s) of Visit Visitor Last Name Visitor First Name & Middle Initial

CAC

(Y/N) In

JPAS

(Y/N)

GOV

PIV

(Y/N)

TWIC

(Y/N) Vetting Form Provided (Y/N)

7/23/18 @10:00AM

Y

EXPECTED VISITOR(S) FORM INSTRUCTIONS

NSASP 5512/17V (Rev 04-11) Box 1. Date(s) of Visit - The date or dates that the visitor will require access to the installation.

Box 2. Visitor Last Name - Spelling that appears on Federal Government or State Issued Photo ID.

Box 3. Visitor First Name and Middle Initial - Spelling that appears on Federal Government or State Issued Photo ID. (Be sure not to use nicknames.)

Box 4. Citizenship – Identify if visitor is a U.S. Citizen or Non-Citizen (State exact country if non U.S. citizen).

Box 5. Representing Company/Command – Name of the Company or Government Activity.

Box 6. Visit Bldg # - Identify the building that visitor will be visiting.

Box 7. Restricted Area/Admin Area – Identify if the visitor needs access to the NSF Indian Head or Stump Neck Annex restricted area(s) or state Admin. NSF Dahlgren does not need to fill this column out.

Box 8. CAC (Y/N) – Self explanatory. NOTE: CAC card does not grant access to the Restricted Areas.

Box 9. In JPAS (Y/N) – If person is in JPAS, they do not require any further vetting and can be issued a Daily Visitor Pass.

Box 10. Gov PIV (Y/N) – The PIV is the Personal Identify Verification card for federal employees and federal contractors. Example: FEMA, DOE, DHS. These are accepted for vetting purposes but individuals that have one of these cards will require getting a Daily Visitor Pass from the appropriate Pass & ID Office for unescorted access.

Box 11. TWIC(Y/N) – The TWIC is the Transportation Worker Identification Card. These are accepted for vetting purposes but individuals that have one of these cards will require getting a Daily Visitor Pass from the appropriate Pass & ID Office for unescorted access.

Box 12. Vetting Form Provided (Y/N) – Is required for any visitor not holding one of the above cards.

Box 13. POC – The person that visitor(s) will be coming in to see.

Box 14. POC Phone # - Phone number of POC during normal working hours.