JADOC Visitor Request Form_Nov.2021.pdf

VISIT REQUIREMENTS:

OPERATIONAL BRIEFING

SITE VISIT - AVENGER

MEETING WITH LEADERSHIP

MEETING WITH STAFF

JADOC FORM 1-1, NOVEMBER 2021 Page 1 of 2PREVIOUS EDITIONS OF JADOC VISITOR REQUEST FORM ARE OBSOLETE.

JADOC VISIT REQUEST AND SECURITY CLEARANCE CERTIFICATION

DATE

PRIVACY ACT STATEMENT, 1974, 5 USC, SECTION 552A

AUTHORITY: EO 13526, Classification National Security Information, AR 380-5. PURPOSE: To identify personnel seeking approval to visit the JADOC when access to classified information is, or may be involved, to preclude unauthorized disclosure of classified defense information.

ROUTINE USES: Information contained herein is used for certification of individual's security clearance and access authorization.

DISCLOSURE IS VOLUNTARY: Failure to provide required information may result in disapproval of access to classified information and areas.

INSTRUCTIONS

Complete SECTION A only. Transmit completed form via e-mail to JADOC.Visitor.Control@us.af.mil at least 72 hours prior to visit.

FROM

Name (Last, First):

Rank/Position:

Organization:

Phone:

SECTION A - VISIT REQUEST (Completed by Requester)

TO

Joint Air Defense Operations Center

Attn: Visitor Coordination Office (VCO) 7400 McGuire Avenue Southwest Joint Base Anacostia-Bolling, District of Columbia 20032

REQUEST APPROVAL FOR THE FOLLOWING INDIVIDUAL(S) TO VISIT THE JADOC.

(List all personnel participating in visit. If you need additional spaces, use page 2.)

If submitting clearance through DISS, use SMO Code: 224 JADOC DET 1/2 and write DISS in the SSN block below. If clearance information is not in DISS, have security manager submit verification to JADOC.Visitor.Control@us.af.mil, or by FAX: (202) 404-6415.

NAME (Last, First, M.I.)

1.

RANK/GRAD E SSN UNIT DUTY POSITION

2.

3.

4.

5.

FROM

DATE OF VISIT

TO

TIME OF VISIT

JUSTIFICATION/NECESSITY OF VISIT: (What is your need to know?)

JADOC SPONSOR NAME (Rank First Last) SPONSOR TELEPHONE NUMBER SPONSOR'S SIGNATURE

SECURITY CLEARANCE VERIFICATION

SIGNATURE

SECTION B - INTERNAL JADOC USE ONLY

3 4 5

BRIEFER

ROOM

SITE(S)

SITE ESCORT

CATEGORY:

II: Brief/Sim III: Office Call IV: Testing V: Coordination/Mtg VI: Support/MaintI: Brief/Sim/Site

BRIEFING ATTENDEES:

OPS FLOOR SIM

SITE VISIT - NASAMS

MAINTENANCE/TESTING

INSPECTION

JADOC FORM 1-1, NOVEMBER 2021 Page 2 of 2PREVIOUS EDITIONS OF JADOC VISITOR REQUEST FORM ARE OBSOLETE.

JADOC VISIT REQUEST AND SECURITY CLEARANCE CERTIFICATION

DATE

PRIVACY ACT STATEMENT, 1974, 5 USC, SECTION 552A

AUTHORITY: EO 13526, Classification National Security Information, AR 380-5. PURPOSE: To identify personnel seeking approval to visit the JADOC when access to classified information is, or may be involved, to preclude unauthorized disclosure of classified defense information.

ROUTINE USES: Information contained herein is used for certification of individual's security clearance and access authorization.

DISCLOSURE IS VOLUNTARY: Failure to provide required information may result in disapproval of access to classified information and areas.

INSTRUCTIONS

Complete SECTION A, only. Transmit completed form via e-mail to JADOC.Visitor.Control@us.af.mil, at least 72 hours prior to visit.

SECTION A - VISIT REQUEST (Completed by Requester)

FROM

Name (Last, First):

Rank/Position:

Organization:

Phone:

TO

Joint Air Defense Operations Center Attn: Visitor Coordination Office (VCO) 7400 McGuire Avenue Southwest Joint Base Anacostia-Bolling, District of Columbia 20032

NAME (Last, First, M.I.) RANK/GRADE UNIT DUTY POSITION

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

INTERNAL JADOC USE ONLY

SECURITY CLEARANCE VERIFICATION

6 7 8 9 10

11 12 13 14 15

REQUEST APPROVAL FOR THE FOLLOWING INDIVIDUAL(S) TO VISIT THE JADOC.

(List all personnel participating in visit. If you need additional spaces, use page 2.)

If submitting clearance through DISS, use SMO Code: 224 JADOC DET 1/2 and write DISS in the SSN block below. If clearance information is not in DISS, have security manager submit verification to JADOC.Visitor.Control@us.af.mil, or by FAX: (202) 404-6415.

SSN