AMAG_FORM.pdf

PDF 321 KB Posted

Attached to
Kingsville Airfield Runway Repair, NAS Kingsville, TX
Solicitation number
N6945018R0505
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AMAG_FORM.pdf

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Text version

Last Name: First Name (no nicknames): Middle Name (mandatory):

Are you a US Citizen? Card Number

Company Name: Drivers License No: Telephone number

Home Address:

City: State: Zip Code:

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.

Revised: November 14, 2012

"For Official Use Only"

"FOR OFFICIAL USE ONLY"

AMAG

Access Management System

NAVFAC SE CIVILIAN SPONSOR:

PHONE NUMBER:

This information will be entered into AMAG in preparation for your arrival - passes picked up at BLDG. 9.

Purpose of Pass:

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