Attachment J.1 - 1818 Visitor Notification.pdf

PDF 115 KB Posted

Attached to
RFQ - Golf Cart Path Extension DLA Susquehanna
Solicitation number
NAFUA1-25-Q-0015
Issued by

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Written by GovTribe AI ·

The document is a DLA Form 1818 Visit Notification form for accessing a Defense Logistics Agency (DLA) installation. The form is part of the NAFUA1-25-Q-0015 solicitation for a golf cart path extension project at DLA Susquehanna in New Cumberland, Pennsylvania. The visit notification is used to control access and movement on DoD installations, with the visitor (Doe, John M.) pre-registering through the DLA enrollment website. The form includes sections for visitor details, purpose of visit (listed as interview, medical meeting, etc.), and spans a visit from January 1-2, 2023, though this appears to be a template or sample form related to the golf cart path extension solicitation.

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PRIVACY ACT STATEMENT

VISIT NOTIFICATION

1. ACTIVITY TO BE VISITED

AUTHORITY:

PRINCIPAL PURPOSE:

ROUTINE USES:

DISCLOSURE:DEFENSE LOGISTICS AGENCY

8725 JOHN J. KINGMAN ROAD

FT BELVOIR, VA 22060-6220

Section 21, 50 U.S.C. 781 et seq.; Executive Order 10450.

To control access to and movement on DoD installations, buildings, or facilities.

Used by General Services Administration Protective Service Personnel for access control and for any of the Blanket Routine Uses published by DLA.

Voluntary. However, failure to provide all the requested information may result in refusal to grant access to the installation, building, or facility.

DLA PRIVACY ACT SYSTEM NOTICE S500.50 DLA-I APPLIES

SECTION I

2. NAME OF REQUESTOR/PREPARER 4. TELEPHONE3. OFFICE CODE

5. DATE(S) OF VISIT 6. POINT OF CONTACT (at facility to be visited) 7. POC TELEPHONE

8. PURPOSE OF VISIT

SECTION II

9.

NAME(S) OF VISITOR(S)

(Last, First, MI)

10.

GRADE/RANK

11.

SSN

12.

DATE OF BIRTH

13.

STATE /COUNTRY OF

BIRTH

14.

CLEARANCE/DATE

GRANTED

15.

TYPE OF INVESTIGATION/

DATE

16. TYPED NAME OF SECURITY REPRESENTATIVE

SECTION III

18. ACTIVITY 19. TELEPHONE NUMBER 20. DATE17. SIGNATURE OF SECURITY REPRESENTATIVE

DLA FORM 1818, JUL 96 (EG)

FROM: TO:

PDF (DLA)

RequesterName: John Doe
OfficeCode: D, DD, DM, DF, ect
FacPOC: John Doe
Phone: 717-770-xxxx
POCPhone: 717-770-xxxx
VisitedActivity: HR, CDC, FWMR, ect..
VisitPurpose: List purpose of visit; Interview, medical, meeting, etc..

Visitor has registered utilizing the pre-enrollment website: https://dbids-global.dmdc.mil/enroll

DateTo: 2 Jan 23
Visitor:
0: Doe, John M.
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DateFrom: 1 Jan 23
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