NSGB_Entry_Forms.DOCX

Welcome to Guantanamo Bay!

I am your sponsor, so if you have any questions, please ask. My contact information is as follows:

Last Modified: 13NOV19 Sponsor Name:

Position:

Unit: Email:

Work Phone:

Tommy Ivey Facility Services Contract Manager Public Work Department, NAVSTA Guantanamo Bay Tommy.L.Ivey.civ@mail.mil 757-458-5621

As a sponsor, I am committed to ensure you accomplish what your work requires. Please understand that the process you are about to undergo is rather rigorous and bureaucratic, but the intent is for your safety. The intent is that we have to accountability of personnel at all times, especially in the event of an emergency.

The process is to fill out the attached forms:

1. Guantanamo Bay Navy Housing Personnel Entry Information Sheet

2. NAVFAC-PWD Guantanamo Bay Entry Clearance Cover Sheet

3. NAVPTO Supported AMC Flight Reservation Request

4. Department of Navy Base Access Pass Registration

All forms should be submitted no later than four weeks from your arrival date. Foreign nationals should be submitted up to 6 weeks prior to arrival. Based on your visitor type and how you are arriving on the island, you may not have to fill out all forms.

For DoD (Department of Defense) employees with a CAC card:

The only form you will be required to fill out is 2. NAVFAC-PWD Guantanamo Bay Entry Clearance Cover Sheet. For base entry, you present a copy of your orders, passport, and CAC card upon arrival. You also do not need to fill out the AMC Flight Reservation Request. When completing orders through DTS, you will need to request CTO assistance to book the AMC flight into GTMO, departing either Norfolk or Jacksonville NAS. You do not need to fill out the housing form, but you will need to acquire reservations through Navy Lodge or NGIS.

For All Other Visitors:

All forms must be completed and submitted, with the exception of the AMC Flight Reservation Request. The AMC flight flies out of Jacksonville NAS.

You are not authorized to arrive early or depart later than unless approval by security has been obtained

RECOMMENDED PROCEDURES TO FOLLOW . . .

FIRST, GET AIRLINE RESERVATIONS

As previously stated, DoD employees on orders will obtain airline reservations through DTS. AMC flights from Jacksonville NAS occur every Friday and every other Tuesday.

SECOND, OBTAIN LODGING RESERVATIONS

Navy Lodge:

Email: navylodge.guantanamobay.guestservice@nexweb.org Phone: DSN 660-3103 or Commercial: 757-458-3103

Navy Gateway Inns & Suites Email: ngismail@gtmo.navv.mil Phone: DSN 660-2040/2044 or Commercial: 757-458-2040/2044

Current residents in family housing may allow visitors to reside at their homes, with the residents approval.

THIRD, GET A RENTAL CAR

Car rentals at Guantanamo Bay are difficult to obtain. When military commissions are in progress car rentals and lodging reservations may not be possible, so please be aware of this possibility. Car rentals are managed by Navy Exchange, and they currently do not have the ability to make reservations past the next day. Therefore, they will place your name on a list for the dates you wish to reserve a car, and allow you to obtain a car rental upon your arrival. This is obviously not reliable, but this has not been a problem up to this point, excepting when commissions are in progress.

To make reservations, contact: Email: Dwight.Douglas.FN@nexweb.org Phone: Commercial: (757) 458-4856

DoD personnel on orders may arrange to have a government vehicle reserved through the transportation department. Contact your sponsor if you wish to exercise this option.

FOURTH, SUBMIT ALL FORMS WITHIN 3 WEEKS OF ARRIVAL DATE

All forms should be submitted with 30 working days (4 weeks) before arrival. This is to allow for everyone to process all the forms. When extenuating circumstances exist, forms can be approved sooner, but this is normally only done in extreme circumstances due to the amount of time and effort needed to get everyone to complete approval quickly. Please remember that sponsorship and approval entry form administration is normally done by individuals that have other primary duties, and processing forms as sponsors requires time away from their normal daily routine.

Please remember, when filling out the forms, if you are unsure as to how to fill in a blank, do your best to enter in the information, or leave blank. Some of the information on some of the forms have been pre-filled by your sponsor, so do not change the pre-filled information unless requested to do so.

Please remember that you will be staying in Cuba, a country that speaks Spanish as the primary language. Learning a few Spanish words and phrases will be useful. Also, the majority of workers here are either Jamaican or Philippine, so attempting to learn to speak Patois and Tagalog will also help during your stay.*** ! IMPORTANT TRAVEL INFORMATION ! ***

Of course, if you believe the last sentence, you have been fooled once. Learning to speak another language is always good in broadening your horizons, but it is not required at Guantanamo Bay. The reason I joke about this is because you should make every attempt not to be fooled a second time, by making assumptions when traveling to Guantanamo Bay. Please ask your sponsor any and all questions so that your visit will go as smooth as possible. Although this is a great place to visit (unless your destination is the detention camps), there is the possibility of something odd arising.

FLIGHT INFORMATION

For AMC flights, you normally have to fly into Norfolk NS or Jacksonville NAS the day prior, since AMC flights depart early morning. You will need to provide a copy of your orders each time you check-in at the AMC terminal of your departure location. If staying at a Navy Lodge or NGIS at Jacksonville or Norfolk, they normally provide a bus to the terminal early morning of flights. Please check with your lodging location for complete information.

NAS Jacksonville allows for early check-in the day prior to the AMC flight to Guantanamo Bay. This will allow you to secure your boarding pass and have your luggage weighed, saving time the following morning. Norfolk may also allow for early check-in. Please contact the terminal for more information.

ARRIVAL INFORMATION

All flights to Guantanamo Bay arrive on the Leeward Side of the island at the air terminal. Upon arrival, you will clear security, and exit the terminal and take one of the buses for transportation to the ferry.

· For AMC flights, you do not need to wait for your checked baggage, as it will be delivered to the Windward side of the island automatically. Your checked baggage can be picked-up at the Windward Terminal Annex after 2:30PM the day of your arrival. Your sponsor will show where this is located.

The ferry will transport you across the bay to the Windward side of the island. The ferry departs the leeward side every even hour, i.e. 10:00AM, 12:00PM, 2:00PM, 4:00PM, etc. Therefore, depending upon your arrival time, you may or may not have to wait for the ferry.

Upon arrival at the Windward side, your sponsor will meet you there (although sometimes your sponsor can greet you at the air terminal). You will be taken to obtain your car rental and check-in with your lodging reservation.

DEPARTURE INFORMATION

· For AMC flights, you will need to provide a copy of your orders at check-in. Check-in occurs between 12:00PM (noon) and 4:00PM the day prior to your flight at the Windward terminal annex. You provide your baggage for weigh-in and obtain your boarding pass.

It is important to take the ferry across the bay the morning of your flight early enough to allow for ample time to check-in at the Leeward terminal. The ferry departs the Windward ferry landing every other half hour, i.e. 7:30AM, 9:30AM, 11:30AM, etc. For AMC flight days, the ferry will make special runs across the bay at 10:30AM due to the number of people flying in and out of Guantanamo Bay.

As always, ask your sponsor for any additional information!

NAVFAC-PWD GUANTANAMO BAY

ENTRY CLEARANCE COVER SHEET___________

VISITOR INFORMATION: Contract #(if applicable) Military Branch: Rank: Last, First, Middle: Passport #: Expiration: Citizenship:

CONTRACTING AGENCY VERIFICATION:

Contract number has been verified to be current and active.

(Signature of Govt. Contract Rep)

Government is not responsible for any renewals or updates to/of entry clearances status. Entry clearance documentation is required to be on your person at all times.

ACKNOWLEDGEMENT: [Signature]

SPONSOR: DATE: ADMINISTRATION: DATE: _

INSTRUCTIONS:

1. Entry clearances are to be submitted no later than 15 business days prior to arrival, completed forms will be provided to Security for vetting 7 work days prior to arrival. For vetting of foreign national (FN) allow 45 days for processing.

2. All travelers to or from NAVSTA, other than active duty military on orders with ID card, are required to have a valid passport…NO EXCEPTIONS.

3. Block 14, Identity Source Documentation: Instructions state that two (2) documents are required; one of the documents MUST be a current passport. Additionally, any documentation noted will need to be presented when checking in for your flight.

NAVPTO SUPPORTED AMC FLIGHT RESERVATION REQUEST

✔ NEW REQUEST MODIFICATION CANCELLATION

Not for use for Space Available travel or travel that is booked through DTS.

Only Travel Support POCs are authorized to submit travel requests to the NAVPTO on behalf of the traveler.

Tamara M Robichaux tamara.m.robichaux.civ@mail.mil

757-458-5603

*** BOARDING WILL BE DENIED IF NAME ON TRAVEL SHEET DOES NOT MATCH ID PRESENTED AT CHECK-IN ***

Last, First, Middle, and (Suffix, if applicable)

Grade

Primary Next of Kin (PNOK) Information (Required for AMC. List only NOK not traveling with member.)

Departing to:

✔ NAS JAX (NIP)

NAS Norfolk (NGU) Kingston, Jamaica (KIN) Arriving from:

✔ NAS JAX (NIP)

NAS Norfolk (NGU) Kingston, Jamaica (KIN)

Additional Information

RESERVATION REQUEST FORM: All fields in the above are required to be filled out. All requests for travel will be sent to the above POC, NO LESS THAN 10 WORKING DAYS prior to requested flight date and sent INDIVIDUALLY via ENCRYPTED email to the NAVPTO Pensacola POC along with a legible copy of the DD‐1610 official orders reflecting the billing address/accounting line and must be signed and dated accordingly. Do not attach more than one travel request per email. SUBJECT line of email for individual requests will look like this: GTMO AMC TRAVEL REQUEST FOR: JOHN DOE If difficulties arise with sending encrypted email, you may send the travel request and supporting documents via the alternate secure delivery method via the following website: https://safe.amrdec.army.mil/safe/Default.aspx . Once received, the NAVPTO POC will review the request as part of the transportation and traffic management process and will ensure that travel is booked accordingly using applicable regulations and provide the sender a PDF copy of the travel sheet that the traveler will provide the AMC ticket counter clerk when checking in.

PRIVACY ACT STATEMENT: The information requested on this form is protected under the authority of 5 U.S.C. 552a to apply for air travel on AMC missions to/from U.S. Naval Base Guantanamo Bay. This standardized form will be: 1. Filled out to request travel reservations for travelers on official orders to/from GTMO that cannot utilize the Defense Travel System (DTS); 2. Sent to NAVPTO Pensacola POC per above guidelines along with a copy of the official orders. Documents will be retained and disposed of per record management directives. Disclosure of the requested information is voluntary. However, completion of the form is necessary to facilitate travel. Failure to provide the requested information will result in delays for arranging travel.

ALL OTHER COMMERCIAL RESERVATION REQUEST FORMS ARE OBSOLETE.

GUANTANAMO BAY NAVY HOUSING

PERSONNEL ENTRY INFORMATION SHEET

Home Phone: Cell Phone: Work Phone:

FLIGHT INFORMATION:

Arrival Date: Depart Date:

CONTRACTOR USE ONLY

STATUS: New or Current Accompanied Unaccompanied Contract Number: Family Member Names:

Company:

ACKNOWLEDGEMENT: [Signature]

****Must be signed by the sponsor (i.e. Military Member stationed in Cuba, DOD employee working in Cuba, or authorized contract representative ****

SPONSOR: DATE:

INSTRUCTIONS:

l . The Housing Office, Building 2295, will stamp clearances for those who will be berthed in Family or Unaccompanied Housing. For reservations with NGIS or Navy Lodge, stamps will need to be obtained from those locations.

2. All travelers to or from NAVSTA, other than active duty military on orders with ID card, are required to have a valid passport ... NO EXCEPTIONS.

3. Block 14, Identity Source Documentation: Instructions state that two (2) documents are required; one of the documents MUST be a current passport. Additionally, any documentation noted will need to be presented when checking in for your flight.

Tommy L. Ivey (757) 458-5621 OMB 0703-0061 Exp 31 Mar 2017

28. Check the applicable box for WORK HOURS box or check the OTHER box and enter the work hours, then check the applicable for WORK DAYS:

WORK HOURS: 00600-1800 or OTHER WORK DAYS: SA M Tu W Th F Su

PRIOR FELONY CONVICTIONS

29. Have you ever been convicted of a Felony? YES NO Initial

REQUIREMENT TO RETURN LOCAL POPULATION ID CARD

30. I understand that I am required to return my Local Population Identification Card to the Base Pass Office when it expires or if my employment is terminated for any reason. (initial)

AUTHORIZATION AND RELEASE AND CERTIFICATION

31. I hereby authorize the DOD/DON and other authorized Federal agencies to obtain any information required from the Federal government and/or state agencies, including but not limited to, the Federal Bureau of Investigation (FBI). the Defense Security Service (DSS). the U.S. Department of Homeland Security (OHS).

I have been notified of DON right to perform minimal vetting and fitness determination as a condition of access to DON installation/facilities. I understand that I may request a record identifier; the source of the record and that I may obtain records from the State Law Enforcement Office as may be available to me under the law. I also understand that this information will be treated as privileged and confidential information.

I release any individual, including records custodians, any component of the U.S. Government or the individual State Criminal History Repository supplying information, from all liability for damages that may result on account of compliance, or any attempts to comply with this authorization . This release is binding, now and in the future, on my heirs, assigns, associates, and personal representative(s) of any nature. Copies of this authorization that show my signature are as valid as the original release signed by me.

FALSE STATEMENTS ARE PUNISHABLE BY LAW AND COULD RESULT IN FINES AND/OR IMPRISONMENT UP TO FIVE YEARS.

BEFORE SIGNING THIS FORM,REVIEW IT CAREFULLY TO MAKE SURE YOU HAVE ANSWERED ALL QUESTIONS FULLY AND CORRECTLY. IDECLARE UNDER PENALTY OF PERJURY THAT THE STATEMENTS MADE BY ME ON THIS FORM ARE TRUE, COMPLETE AND CORRECT

DATE SIGNATURE

FINAL DETERMINATION ON YOUR ACCESS The Base Commanding Officer has final authority for determination on granting physical access to DON controlled installations/facilities under his/her jurisdiction.

BELOW COMPLETED BY BASE REGISTRAR PERSON CONDUCTING IDENTY PROOFING and NCIC CHECK

RECORD NUMBER:

Office of Under Secretary of Defense Directive-Type Memorandum (DTM) 09-012, "Interim Policy Guidance for DoD Physical Access Control," December 8, 2009. DTM 09-012 requires that DoD installation government representatives query the National Crime Information Center (NCIC) and Terrorist Screening Database to vet the claimed identity and to determine the fitness of non-federal government and non-DoD-issued card holders (i.e. visitors) who are requesting unescorted access to a DoD installation. The minimum criteria to determine the fitness of a visitor is: 1) not on a terrorist watch list; 2) not on an DoD installation debarment list; and 3) not on a FBI National Criminal Information Center (NCIC) felony wants and warrants list. Additionally,SECNAV Memo, Policy for Sex Offender Tracking and Assignment and Access Restrictions within the Department of the Navy, of 7 Oct 08 and OPNAVINST 1752.3 established the Navy's policy on sex offenders, requiring Region Commanders (REGCOMs) and Installation Commanding Officers (COs) to prohibit sex offender access to DoN facilities and Navy owned, leased or PPV housing. This form describes the authority and purpose to collect and share the required information ;and identifies the applicant/visitor and sponsor; and authorizes the DoD to perform the minimum vetting and fitness determination criteria. A favorable response on the vetting and fitness determination is required to receive access to DOD-controlled installation/facilities.

SECNAV 551211 (APR 2014) FOR OFFICIAL USE ONLY WHEN FILLED - PRIVACY SENSITIVE

Any misuse or unauthorized disclosure of this information may result in both criminal and civil penalties.

OMB 0703-0061 Exp 31 Mar 2017

Instruction for completing the Local Population Access Registration Form

INSTRUCTIONS: Please complete allinformation in black ink (printed) or by typing. By voluntarily providing your Personal lnformation, you agree to the following terms and restrictions:

RESTRICTIONS: Local Population Identification Card/Base Access Pass may only be used by person to whom they are issued and for the specific business/purpose issued. Applicants are reminded that soliciting (i.e., door-to-door sales) is prohibited on the base, and that such activityis grounds for cancellation of the Pass. Additionally,such action may resultin debarment from the base and legal action. The Base Commanding Officer has discretion over specifying the period of validity for any Local Population ID Cards/Base Access Passes that are i ssued under his/her jurisdiction.

Review the Privacy At Statement that is printed at the top of the form

Block 1: Enter the Last Name.

Block 2: Enter the First Name. Block 3: Enter the Middle Name.

Block 4: If applicable, check the box for Name Suffix.

Block 5: Check the applicable box for Hispanic or Latino. Block 6: Check the applicable box for Race.

Block 7: Check the applicable box for Gender.

Block 8: Enter Dateof Birth. Block 9: Enter City of Birth.

Block 10: Enter State of Birth.

Block 11: Enter Country of Birth.

Block 12: Check the applicable box for US Citizenship.

Block 13: If not a US Citizen, enter the name of the Country of Citizenship.

Block 14: Two forms of identity source documents from the list of acceptable documents listed below must be presented to the base registrar with this completed fonn. Check the box for the type of Documents that will be presented for identity proofing. If the document type is not listed, use the two rows under Other Approved Identity Source Documents to enter the type of document(s) that you will present Block 15: Enter the Document Number located on theIdentity Proofing Source document that was checked in Block 14.

Block 16: Enter the State that issued the Identity Source Document Block 17: Enter the Country thatissued the Identity Source Document Block 18: Enter the Date that theIdentity Source Document wasissued.

Block 19: Enter the Date that theIdentity Source Document will expire. Block 20: Enter Weightin pounds.

Block 21: Enter Height in inches.

Block 22: Check the applicable box for Hair Color. Block 23: Check the applicable box for Eye Color.

Block 24: Enter Home Address lnduding City, State,Zip Code, and Home Telephone Number.

Block 25: Enter Name of Registrant's Base Sponsor and Base Sponsor's Telephone Number.

Block 26: Enter Employer Name and address including City, State, Zip Code, and Employer's Telephone Number.

Block 27: Enter Supervisor's Name including City, State, Zip Code, and Supervisor's Telephone Number.

Block 28: Check the applicable box for Work Hours box or check the OTHER box and enter the work hours, then check applicable boxes for Work Days. Block 28: Check the applicable answer if you have been convicted of Felony and enter initials.

Block 29: Check the applicable box for felony conviction.

Block 30: Enter initials to accept terms for returning LocalPopulationIdentification Card.

Block 31: Sign and date theform to attest that the foregoing infonnation is true and complete to best of your knowledge.

LIST OF ACCEPTABLE DOCUMENTS - All documents must not be expired.

Must present one selection from List A or a combination of one selection from List Band one selection from List C.

list A - Documents that EstablishIdentity and Employment Authorization

OR List B - Documents that Establish Identity AND list C - Documents that Establish Employment Authorization

1. U.S. Passport or U.S. Passport Card.

2. Permanent Resident Card or Alien Registration Receipt Card (Form 1-551).

3. Foreign passport that contains a temporary 1-551 stamp or temporary 1-551printed notation on a machine-readableimmigrant visa.

4. Employment Authorization Document that contains a photograph (Form 1-766).

5. For a nonimmigrant alien authorized to work for a specific employer because of his or her status:

a. Foreign Passport;and

b. Form 1-94 or Form l-94A that has the following:

(1) The same name as the passport;and

(2) An endorsement of the alien's nonimmigrant status as long as that period of endorsement has not yet expired andthe proposed employment is not in conflict with and restrictions or limitations identified on form.

6. Passport from the Federal States of Micronesia (FSM) or the Republic of the Marshal Islands (RM) with Form 1-94 or Form l-94Aindicating nonimmigrant admission under the Compact of Free Association Between the United Stated and FSM or RM.

1. Driver's license or ID card issued by a State or outlying possession of the United States provided it contains a photograph orinformation such as name,date of birth,gender, height, eye color, and address.

2. ID cardissued by federal,state orlocal government agencies or entities, provided it containsa photograph or information such as name,date of birth,gender, height, eye color, and address.

3. School ID card with a photograph

4. Voter's registration card.

5. U.S. Miiltary card or draft record.

6. Military dependent's ID card.

7. U.S. Coast Guard Merchant Mariner Card.

B. Native American tribal document

9. Driver's license issued by a Canadian government authority.

For persons under age 18 who are unable to present a document listed above:

10. School record or report card.

11. Clinic, doctor,or hospital record. 12 Day-care or nursery schoolrecord.

1. A Social Security Account Number card,unless the card includes one of the following restrictions:

(1) NOT VALID FOR EMPLOYMEMT

(2) VALID FOR WORK ONY WITH INS AUTHORIZATION.

(3) VALID FOR WORK ONLY WITH DHS

AUTHORIZATION.

2. Certification of Birth Abroad issued by the Department of State (Form FS-545).

3. Certification of Birthissued by the Department of State (Form DS-1360).

4. Original or certified copy of birth certificateissued by a State, county, municipal authority or territory of the United States bearing an official seal.

5. Native American tribal document

6. U.S. Citizen ID Card (Form 1-197).

7. Identification Card for Use of Resident Citizen in the United States (Form 1-179).

B. Employment authorization document issued by the Department of Homeland Security.

The remainder of the form wi ll be completed by the Base Registrar Person conducting Identify Proofing process and NCIC check.

AGENCY DISCLOSURE STATEMENT:

The public reporting burden for this collection of information is estimated to average 10 minutes per response,induding the time for reviewinginstructions,searching existing data sources, gathering and maintaining the data needed,and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden,to the Department of Defense, Washington Headquarters Services,Executive Services Directorate, Information Management Division, 4800 Mark Center Drive, East Tower, Suite 02G09, Alexandria, VA 22350-3100 OMS 0703-0061. Respondents should be aware that notwithstanding any other provisionoflaw, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMS control number.

PLEASE DO NOT RETURN COMPLETED FORM TO THE ABOVE ADDRESS.

Completed form should be submitted to the Base Registrar.

SECNAV 5512/1 (APR 2014) FOR OFFICIAL USE ONLY WHEN FILLED - PRIVACY SENSITIVE

Any misuse or unauthorized disclosure of this information may result in both criminal and civil penalties.

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