NCIC Base Pass Request.pdf
PDF 88 KB Posted
- Attached to
- Construct South Lot 3
- Solicitation number
- FA460026B0004
About this file
This is a template form (SFS Form 31) for managing visitor entry authorization at Offutt Air Force Base. The form is used by the 55th Security Forces Squadron to document and authorize temporary installation access for events or projects. The document establishes a structured data collection framework with fields for event details, sponsor information, and visitor credentials.
The form captures essential event information including project name, specific start and end times for each day of the week, event dates with immediate expiration upon conclusion, and the physical location on Offutt AFB. Sponsor details including name, rank, and contact phone numbers are required fields to be completed by Civil Engineering Squadron (CES). Visitor information must include legal name, gender, date of birth, driver's license number and issuing state, and U.S. citizenship status. The form accommodates up to 18 guest entries and includes mandatory Privacy Act statement language citing 10 U.S.C. 8013 and Executive Orders 13478 and 9397 as authorization authority. Records are maintained in the Security Forces Management Information System (SFMIS) and Defense Biometric Identification Systems (DBIDS). The form explicitly states it cannot be modified in format and requires approval stamp and authenticator signature by Security Forces personnel only.
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Text version
FOUO OFFUTT AIR FORCE BASE ENTRY AUTHORITY LIST
Page of 55 SFS Form 31 (10 Apr 2015)
Event Name Project NAME
Start and End Time for Each Day of Event Monday Tuesday Wednesday Thursday Friday Saturday Sunday
TTTT-TTTT TTTT-TTTT TTTT-TTTT TTTT-TTTT TTTT-TTTT TTTT-TTTT TTTT-TTTT
Date(s) of Event (Expires Immediately After Event ) Location of Event DDMMYYYY - DDMMYYYY Offutt AFB, BXXX
Sponsor Name and Rank Sponsor Phone Number(s) To be filled out by CES To be filled out by CES
PRIVACY ACT STATEMENT
Authority: 10 U.S.C. 8013 and Executive Orders 13478 and 9397 as amended.
Purpose: Information collected by Security Forces personnel will be used to authorize installation entry to persons shown on the entry authority listing for the specific purpose provided by the sponsor. Information will also be used to notify person(s) designated as the visitor sponsor of arrival and other pertinent information relating to entry on the installation.
Routine Uses: Records may be disclosed to applicable Federal, State, or local agency charged with the responsibility of investigating or prosecuting a violation or enforcing/implementing a statute, rule, regulation, order issued pursuant thereto.
Disclosure: Disclosure of requested information is voluntary. Failure to provide all or parts of information requested can result in denial of installation entry. System of records number F031 AF SF B, Security Forces Management Information System (SFMIS), Defense Biometric Identification Systems (DBIDS) applies.
**DO NOT MODIFY FORMAT**
Approval Stamp (55 SFS Use Only)
Signature of Authenticator (55 SFS Use Only)
Legal Name of Guest:
(Last, First, MI)
Gender:
(M/F)
DOB:
(1962 Jan 11)
Driver’s License# State Issued
(M19GO62BLU / MI)
United States Citizen
(Yes / No)
File details come from the government source that posted it. Updated .