(6)_Attachment_6_DLA_SP_Camera_Pass_Request_Form.pdf

Camera Pass Request Form

Security & Emergency Services

User Name:

Company/Unit:

Phone Number:

Location(s) Required:

Dates/Length of Time (up to 1 year):

Justification:

Signature:

If Contractor, COR or sponsor information and approval/disapproval required

Name:

Phone Number:

Once complete, attach form and send to the Security Management Branch for approval.

Security Management Branch Use:

Approved Disapproved

Pass & ID Use:

Pass #:

Security Assistant:

Date Issued:

I have read and understand the image capturing device policy. All photos will be vetted by the Security Management Branch in accordance with the installation policy.

Printed Name:

Date:

mailto:DSSUSQSECURITY@dla.mil

ADDITIONAL PERSONNEL: The following personnel have reviewed and understand the image capturing device policy. All photos will be vetted by the Security Management Branch in accordance with the installation policy.

USER NAMES SIGNATURE