B-NAS_JAX_Base_Access_AMAG_Form.xls
XLS spreadsheet 31 KB Posted
- Solicitation number
- N6945014R1756
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Attachment B - NAS JAX Base Access AMAG Form
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Sheet1
| AMAG | ||
| Access Management System | ||
| This information will be entered into AMAG in preparation for your arrival - passes picked up at BLDG. 9. | ||
| "FOR OFFICIAL USE ONLY" | ||
| Last Name: | First Name (no nicknames): | Middle Name (mandatory): |
| Are you a US Citizen? | Card Number | |
| 5425841 (leave # in here) | ||
| Company Name: | Drivers License No: | Telephone number |
| Home Address: | ||
| City: | State: | Zip Code: |
| NAVFAC SE CIVILIAN SPONSOR: | ||
| PHONE NUMBER: | ||
| Purpose of Pass: | ||
| Start Date: | End Date: | |
| ***Maximum of 30 days | ||
| SIGNATURE:____________________________ DATE:_____________ | ||
| ***Typed name in Signature line will suffice*** | ||
| Authority: 5 U.S.C. 522A, and Privacy Act of 1974 | ||
| Principle Purpose: To readily identify all personnel via numerical system of records that list individuals who are | ||
| allowed to access the military reservation, known as Naval Air Station, Jacksonville in furtherance of the stations | ||
| mission; and to comply verify and update the stations authorized user list in support of administrative and security | ||
| measures. | ||
| Routine Uses: To numerically identify and account for persons aboard Naval Air Station Jacksonville, their | ||
| entrance, exit and authorized locations. | ||
| For Official Use Only | ||
| Revised: November 14, 2012 |
Sheet2
Sheet3
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