S02 VA ID PACKAGE UPDATED 10-29-2025.pdf

This is a Contract Employee Application Package from the Department of Veterans Affairs (VA), Veterans Health Administration (VHA), specifically the VHA Service Center located in Independence, Ohio. The package contains required forms and procedures for contractor employee onboarding and security clearance processing.

The application package includes multiple required forms and documentation: Background Investigation Request Worksheet (Form #1), which requires contractors to submit updated background information within five business days of the award date; VHA Service Center Contractor PIV Sponsorship Form (Form #2), collecting personal identifying information including SSN, date of birth, physical descriptors, citizenship status, and employment details; VHA Special Agreement Checks (SAC) Memorandum (Form #3), requiring fingerprints to be completed and submitted within five business days of award with results faxed to the VHA Service Center Personnel Security Office; VHA Security Center PIV Credentials Turn-In Inventory Report (Form #4), documenting employee onboarding at VA facilities; Screening Checklist (VA Form 10-0453), tracking completion of required documentation items including federal application forms, declarations, licenses, fingerprints, background check results, and NACI/MBI/BI submissions; Contractor Security Check Form, documenting fingerprint results and HR/police determinations with FBI hit code keys; Fingerprint Record Prep Sheet, collecting biometric data; HIPDB/NPDB forms for health and practitioner database checks; Request for Personal Identity Verification Card (VA Form 0711), the multi-part form for PIV card issuance with applicant information, sponsor verification, identity verification, and card acceptance sections; Declaration for Federal Employment (Form OF-306), assessing fitness for federal contract employment; and Employment Eligibility Verification (Form I-9), documenting work authorization. The package establishes the baseline security and onboarding requirements for all contractor personnel working at VHA facilities, with strict timelines for submission and adjudication of background checks and credentials.