Attachment_5___Installation_Access_and_Vehicle_Registration_Policy.pdf

INSTRUCTIONS FOR COMPLETING THE ASG-KU PMO FORM 190-16.01

ENCLOSURE 1 – Required for all applicants requesting Access

Section I – Demographics:

Blocks 1 – 3: Last Name, First Name, and Middle Name/Suffix Self Explanatory Block 4: Passport Number and Expiration Self Explanatory Block 5: Foreign Identification Number

Kuwait Civil Identification Number or Country of Origin Identification Number

Block 6: Date of Birth Self Explanatory Block 7: Height Enter height in inches Block 8: Weight Enter weight in pounds Block 9: Gender Self Explanatory Block 10: Eye Color Self Explanatory Block 11: Hair Color Self Explanatory Block 12: Title/Position Enter exact Job Title Block 13: Rank/Grade i.e. GS-11E or Contractor Block 14: Citizenship/Nationality

Enter country of citizenship. If holds dual citizenship, the applicant must list BOTH countries

Block 15: Race Enter one of the following:

A – Asian / Pacific Islander / anyone from the Asian continent or Pacific Islands B – Black N – Native American / Alaskan Native W – White / Caucasian / Anglo / European Descent U - Unknown

Block 16: Address Type Enter the type of address that will be listed in Blocks 17 –

Blocks 17 – 19: Address, City, State, Zip Code and Country Enter the address of the type checked in Block 16

Block 20: Home Phone Number Enter the Land Line Phone Number (if applicable)

Block 21: Mobile Phone Number Self Explanatory

Block 22: Work Phone Number Enter phone number of the applicant’s work or office

Block 23: DSN Phone Number Enter DSN Number (if applicable)

Section II – Access Information

Block 24: Purpose of Application

Mark the box that applies to the applicant Blocks 25 – 27: Work Hours, Dates Requested and Work Days Self Explanatory

Section III – Company/Contract Information

Block 28: Employer

Enter the primary company that the applicant is employed with

Block 29: Department/Section Enter the Department and/or Section of the applicant is assigned to

Block 30: Work Location of Employee Enter the location where the applicant works, i.e. Building Number, Zone Location, etc

Block 31: Project Name/Task Order Enter all information as applicable Blocks 32 – 33: Supervisor Name and Work Number

Enter the name of the applicant’s immediate supervisor and the contact number

Block 34: US Military Contract Number Enter the complete contract number

Block 35: Contract Expiration Date Self Explanatory

Block 36: Contract Period Base year of contract plus option years (i.e. Contract expires 30Sep2011, plus 3 option years: Expiration 30Sep2014)

Block 37: Primary Contract Company (if applicable) If individual is a subcontractor, enter the Primary Contract Company Name

Block 38: Primary Contract Company Contact Information (if applicable)

Enter Telephone number, email and/or mailing address of Primary Contract Company

Block 39: Name of Primary Contract Company Representative (if applicable)

Print name of individual that can be contacted for questions concerning the subcontract

Block 40: Signature of Primary Contract Company Representative (if applicable)

Signature of individual who has reviewed application for subcontractor

Block 41: Subcontract Number (If applicable) Block 42: Point of Contact (POC) for Subcontract Company (if applicable)

Section IV – Requesting Authority (RA) Information and Recommendation

Blocks 43 – 49: RA Last Name, First and Middle Name, Rank/Grade or Equivalent, Unit/Organization, Work Number, Mobile Number and E-Mail Address

Enter the information for the Directorate/Contracting Officer Representative (COR) for the applicant.

Block 50: Signature and Date The signature must be of the individual listed in Blocks 43

– 49, must be original and match the Signature Card the IAO has on file. The applicant must process within thirty

(30) days of the application being signed.

Block 51: Areas of Access Mark those areas the applicant is authorized to have access to based on the terms of the contract or orders.

The RA must initial all areas required. Special Areas such as Bag Farms can be listed in Block “Other”.

Block 52: Personal Access in Force Protection Condition

(FPCON)

SP4510-13-R-0002

Attachment 5

Mark the authorized FPCON level for the applicant. The RA must initial the block for verification and provide written justification in Block 55 for FPCON Delta. (RA initials required).

Block 53: Vehicle Access in Force Protection Condition

(FPCON)

Mark the authorized FPCON level for the applicant’s vehicle access. The RA must initial the block for verification and provide written justification in Block 55 for FPCON Delta. (RA initials required).

Block 54: Escort Privileges The RA must initial the block and provide written justification in Block 55 for escort privileges. This is primarily assigned to Supervisors, Project Managers, Human Resources personnel, and Emergency Essential positions. (RA initials required).

Block 55: Areas, Gates and Base Access (other Remarks) Enter justification for Blocks 51 – 54, or other area requests. (RA initials required).

Block 56: Expiration Date Recommended date for IA card expiration; cannot be greater than one (1) year. (RA initials required).

Section V – IA Card Holder Acknowledgement

Blocks 57 – 60: Names (Printed), Signature and Date

Applicant must read and acknowledge IA Card Holder Responsibilities, then print, sign and date before IA Card can be issued

Section VI – Access Office Use Only

Blocks 61 – 74: DO NOT WRITE IN THIS AREA

Section VII – Screening Office Use Only

Blocks 75 – 77: DO NOT WRITE IN THIS AREA

OTHER IMPORTANT INFORMATION:

1. If you are a Western Contractor, begin your renewal process with Pass & ID 30 days before the expiration date of your IA card.

2. If you are a Foreign National Contractor, begin your renewal process with Pass & ID 45-60 days before the Expiration of your IA card.

3. All Foreign Nationals must have an interview by the Screening Office prior to being processed for access.

4. All signatures and initials must be present on the application and must be original before anyone can be processed for access.

5. The applicant is responsible to provide all documents listed in Enclosure 2 at the time of processing or the application will be denied.

6. Original Passport must be presented at the time of processing.

7. Escorted Access Requests must be turned in 48 hours in advance for processing.

8. Exceptions to Policy may require additional screening and/or interview.

9. Exceptions to Policy may take three (3) days or more to process depending on the authority that must approve it.

ASG-KU ACCESS APPLICATION

Data Required by the Privacy Act of 1974 (5 USC 552a), DoD Directive 5400.11-R, 10 USC 3013, 10 USC 5013, 10 USC 8013 and Executive Order 9397

AUTHORITY: 10 U.S.C. 113, Secretary of Defense, Note (Use of Smart Card Technology in the Department of Defense); Directive-Type Memorandum (DTM) 09-012, Interim Policy Guidance for DoD Physical Access Control; 10 U.S.C. 136, Under Secretary of Defense for Personnel and Readiness; DoD Directive 1000.25, DoD Personnel Identity Protection (PIP) Program; DoD Instruction 5200.08, Security of DoD Installations and Resources; DoD 5200.08-R, Physical Security Program; and E.O. 9397 (SSN), as amended.

PRINCIPAL PURPOSE(S): The records support DoD physical security and information assurance programs, to issue individual facility/installation access credentials, and for identity verification purposes. The system also is used to record personal vehicles and property registered with the DoD and for producing facility management reports. The records may be accessed by other physical access control systems for further verification at other sites. Records may also be used for law enforcement purposes.

ROUTINE USE(S): In addition to those disclosures generally permitted under 5 U.S.C. 552a (b) of the Privacy Act of 1974, these records may specifically be disclosed outside the DoD as a routine use pursuant to 5 U.S.C. 552a (b) (3) as follows: Under DoD Blanket Routine Use #1. For law enforcement purposes to …federal, state, local, or foreign (law enforcement agencies), charged with enforcing or implementing the statute, rule, regulation, or order issued pursuant thereto. The DoD 'Blanket Routine Uses' set forth at the beginning of the OSD compilation of systems of records notices apply to this system.

DISCLOSURE REQUIREMENT – THIS INFORMATION IS VOLUNTARY: Voluntary. However, failure to provide the requested information may result in denial of a DBIDS card or visitor’s pass and denial of entry to DoD installations and/or facilities.

CONDITIONS APPLICABLE ON RECEIPT: I understand that the ASG-KU Installation Access (IA) Card is valid only through the expiration date indicated. Exceptions may require additional screening, interview and background checks. It should also be known that any derogatory information returned from the applicant's background investigation or failure to comply with screening/interview requirements may reflect adversely on consideration for access and may result in barment proceedings being initiated. Its intended use and authorizations are limited to those indicated on this form and the card. I understand that the ASG-KU IA Card is US Government property, that it is not transferable, that it is not to be altered in any way, and that it must be surrendered upon request of the US Government, its designated representative, or the issuing agency. I understand that while on any ASG-KU Installation my person, possessions, vehicle and work area are subject to search at the discretion of the US Government or its designated representative. I understand that I am liable for the cost of replacement for my IA Card if lost. Any falsification on this form will result in immediate revocation of access privileges.

SECTION I – Demographics

Last N am e:

1. Last Name (Surname):

12. Title/Position:

13. Rank/Grade:

2. First Name (Given Name):

14. Citizenship/Nationality (If dual Citizen list both countries):

15. Race:

3. Middle Name/Suffix:

16. Address Type:

Organization Address Company Address Home Address Office Address

4. Passport Number:

Expiration Date (yyyy/mmm/dd):

17. Address (Building Name/Number, Street Name/Number, etc):

5. Foreign Identification Number:

Expiration Date (yyyy/mmm/dd):

18. City, State, Zip code:

19. Country:

First N

6. Date of Birth (yyyy/mmm/dd):

7. Height (inches):

8. Weight (pounds):

20. Home Phone Number:

21. Mobile Phone Number:

9. Gender:

Male Female

10. Eye Color:

11. Hair Color:

22. Work Phone Number:

23. DSN Phone Number:

SECTION II – Access Information

24. Purpose of Application

CAC TDY Escort Request New Registration Renew Registration Upgrade of Privileges Lost/Damaged Card

ID

N um ber:

25. Work Hours:

From:

To:

26. Dates Requested:

From:

To:

27. Work Days:

Sat Sun Mon Tue Wed Thu Fri

SECTION III – Company/Contract Information

28. Unit/Employer:

29. Department and Section:

30. Work Location of Employee:

31. Project Name/Task Order:

D B

ID

S N

32. Supervisor Name:

33. Supervisor Work Number:

34. US Military Contract Number:

35. Contract Expiration Date (yyyy/mmm/dd):

36. Contract Period (Base plus option years):

37. Primary Contract Company:

38. Primary Contract Company Contact Information:

39. Name of Primary Contract Company Representative:

40. Signature of Primary Contract Company Representative:

41. Subcontract #:

42. Subcontract Point of Contact (POC):

ASG-KU ACCESS APPLICATION

SECTION IV – Requesting Authority (RA) Information and Recommendation Last N

43. RA Last Name:

44. RA First and Middle Name:

45. RA Rank/Grade or Equivalent:

46. RA Unit/Organization:

47. RA Work Number:

48. RA Mobile Number:

49. RA E-Mail Address:

50. Signature and Date:

51. Areas Of Access Directorate/COR/RA must initial for each camp required.

(Note: Access is based on the individual’s need as stated in their contract.

It is strictly prohibited to access areas not specified in their contract.)

Camp Arifjan

Initials:________

Camp Buehring

Initials:________

SPOD – w/Enc 7

Initials:________

Khabari – w/Enc 7

Initials:________

Camp Virginia

Initials:________

LSA

Initials:________

KNB (Patriot)

Initials:________

Other:

Initials:________

U.S. Border Crossing – Access via Iraq/Kuwait Border Initials:________

52. Personal Access in Force Protection Condition: Initials:

CHARLIE DELTA

Submit justification in Block 55 for ‘Delta’ Access

53. Vehicle Access in FP Condition: Initials:

CHARLIE DELTA NO VEHICLE

Submit justification in Block 55 for ‘Delta’ Access

54. Escort Privileges: Initials:

NO YES

Submit justification Block 55 for ‘Escort Privileges’

55. Remarks: (Specific Areas Access; Personal/Vehicle FPCON DELTA Access or Escort justification)

56. Expiration Date Recommendation: Initials:

SECTION V – Installation Access (IA) Card Holder Acknowledgement

First N

57. Acknowledgement of ASG-KU IA Card Holder Responsibilities As a ASG-KU IA Card holder, I acknowledge the following:

1. All persons, their personal property, US Government property, and vehicles may be searched on entry, while within the confines of, or when leaving US Forces installations. Persons attempting to gain entry, who refuse to identify themselves, provide digitized fingerprint minutia data (DFMD), hand geometry scan, or consent to search, will be denied access.

2. If I am authorized escort privileges, I understand that I am agreeing to monitor that person’s actions at all times, and I accept full responsibility for that person’s conduct while on the installation.

3. IA Cards are US Government property. Any Military Police Officer, Law Enforcement, Security Force or Access Control personnel may confiscate an IA Card that has expired, is being used fraudulently, and is being presented by a person other than the person to whom it was issued, or is obviously altered, damaged, mutilated or photocopied.

4. I must surrender my pass when

a. It is replaced (except when lost or stolen).

b. I no longer require access.

c. My sponsor or status changes.

d. I resign, am terminated, or am no longer officially sponsored.

5. If I lose my IA Card or if it is stolen, I must immediately notify either the Law Enforcement Station or Installation Access Office. Failure to do so is grounds for denying a replacement card.

6. Violations of ASG-KU security policies may be grounds for denying access to US Forces Installations and lead to confiscation of all installation access documents.

I acknowledge by my signature that I have read and understand the policy, requirements, and responsibilities above.

58. (Print) Last, First, MI:

59. Signature: 60. Date (yyyy/mmm/dd):

SECTION VI – Access Office Use Only

ID

N

61. Name and Rank/Title of Person Approving Application: 62. Signature Date of Person Approving Application: 63. Expiration Date of IA Card (yyyy/mmm/dd):

64. Personal Access in Force Protection Condition:

CHARLIE DELTA

65. Vehicle Access in Force Protection Condition:

CHARLIE DELTA NO VEHICLE

66. Escort Privileges:

NO YES

67. Areas, Gates, and Base Privileges Granted (other Remarks):

68. Category Classification:

CAT 1 - Foreign National CAT 2 - Foreign Military CAT 3 - Non Screened US CAT 4 - Screened US CAT 5 - Commander’s Exception

69. Name of Person Entering Data/Collecting Biometrics: 70. Signature and Date of Person Entering Data/Collecting

Biometrics:

71. DBIDS Number of Person Entering Data/Collecting Biometrics:

D B

ID

S N

72. Verifying Documents enclosed:

Copy of Passport (photo, data and residency) Copy of CAC (front & back, if applicable) Copy LOI, LOA or Orders Copy Kuwait Entry Visa with entry stamp Copy of Kuwait or GCC driver’s license Copy of Home of Record driver’s license RA Signature Verification (COR) Exception to Policy (completed and signed)

Original Sponsor Letters (English and Arabic) Contractor Sponsor Letters (English and Arabic) Kuwait CID Cover Letter Contract Validation Letter (Khabari Crossing /

SPOD)

U.S. AD Retiree Limited Access Memorandum Copy of KMOI / KMOD / J-2 Pass Copy of US Permanent Resident Card Other: _________________________________

73. Vetting Date:

74. DBIDS Number of Applicant:

SECTION VII – Screening Office Use Only

75. Name of Screener:

76. Signature of Screener and Date:

77. Screening Status:

Approved

Rejected

Routed to PM

DATE:

TO: Area Support Group – Kuwait (ASG-KU)

ATTN: Provost Marshal Office/Pass & ID

The following individual is authorized access per contract to the following ASG-KU Installations:

The Contract Company listed below acknowledges and accepts full responsibility for the conduct and action of the employee while working on ASG-KU Installations and will comply with all rules and regulations for access.

1.) NAME (Last, First, Middle):

2.) Passport Number:

3.) Kuwait Civil ID #:

4.) Primary Contract Company:

5.) US Military Contract Number:

6.) End of Contract (yyyy/mmm/dd):

7.) Subcontract Company (if Applicable):

8.) Subcontract # (if Applicable):

I hereby acknowledge and accept responsibility for the conduct and actions of the above named employee.

Directorate/Company/Project Manager Acknowledgement and Signature (Please ensure that the Signature Block includes Full Name, Title, Company Name, Signature and Date)

*NOTE: Personnel employed by a Sub-Contract Company are required to have a LOI/LOA from the Primary Contractor IN ADDITION TO one from the Sub-contract Company.

Required Supplemental Documentation Checklist by Person Category

This documentation must be submitted to the Installation Access Office at the time of processing.

Due to the amount of applications the Installation Access Office must process daily, we cannot make copies of required documentation for customers.

****NOTE: All “ASG-KU Notice of Delegation of Authority” must be accompanied by a copy of the front side ONLY of each person’s CAC card****

1. U.S. Contractors: Those individuals with a valid U.S. Passport, U.S. Permanent Resident card holders; Contractor CAC holders in-country more than 90 days in a 365 day period; Military Affiliated Military Retirees (includes those employed on a Host Nation/Coalition Government Contract within the KTO but outside of ASG-KU Installations):

ASG-KU PMO Form 190-16.01, completed and signed by Requesting Authority.

Original passport must be presented at the time of badging.

Copy of passport photo and data pages.

Copy of SPOT LOA, LOI, Travel Orders and /or Contract (Prime Contractor).

If the individual is a sub-contractor, an additional letter from the sub-contract company is required.

Copy of Valid Driver’s License if requesting Vehicle Privileges. IAW with Kuwait Common Law, those persons with Kuwait residency must have a Kuwait

DL. A Home of Record Driver’s License may be used only if the applicant is not required to obtain residency.

- WITH EITHER -

Copy of Entry Visa or Kuwait entry stamp. (Applicants will only be given an IA card for the length of their Entry Visa up to a maximum of 90 days).

- OR -

Copy of Visa 17 or 18 Residency page from passport. (IAW Host Nation Labor Laws and KMOD Guidance, applicants must apply for a Kuwait residency if employed in Kuwait on a Military Installation for more than 90 days in a 365 days period).

Copy of Civil ID (front and back). If Available.

2. U.S. Military/ Service Civilians and Dependants (those authorized ASG-KU IA Card):

Original CAC must be presented at time of registration.

Driver’s License.

Copy of Orders.

Validation of status from ASG-KU CPO List

- OR –

Copy of Memorandum authorizing Off-Post Housing/Single Occupancy Travel (for initial access ONLY). This includes TDY personnel.

3. U.S. Military/ Service Civilians (those not authorized ASG-KU IA Card): IAW the Installation Access and Vehicle Registration Policy, all Military/ Service Civilians are required to register their CAC as part of the in-process to the KTO.

Copy of Orders.

Original CAC must be presented at time of registration.

4. Nationals from New Zealand, Australia, Canada or the United Kingdom (UK) w/Ireland:

Original Passport must be presented at time of badging.

Copy of passport picture and data pages.

Copy of SPOT LOA, LOI, Travel Orders and /or Contract (Prime Contractor).

If the individual is a sub-contractor, an additional letter from the sub-contract company is required.

Copy of Valid Driver’s License if requesting Vehicle Privileges. IAW with Kuwait Common Law, those persons with Kuwait residency must have a Kuwait DL. A Home of Record Driver’s License may be used only if the applicant is not required to obtain residency.

- WITH EITHER –

Copy of Entry Visa or Kuwait entry stamp. (Applicants will only be given an IA card for the length of their Entry Visa up to a maximum of 90 days).

- OR –

Copy of Visa 17 or 18 Residency page from passport. (IAW Host Nation Labor Laws and KMOD Guidance, applicants must apply for a Kuwait residency if employed in Kuwait on a Military Installation for more than 90 days).

Copy of Civil ID (front and back). If Available.

5. Foreign Nationals from all other Countries:

Original Passport must be presented at time of badging.

Copy of passport picture and data pages.

Copy of Visa 18 Residency page from passport. (IAW Host Nation Labor Laws and KMOD Guidance, applicants must apply for a Kuwait residency if employed in Kuwait on a Military Installation for more than 90 days).

Copy of Civil ID (front and back). If Available.

Kuwait CID Cover Letter typed in Arabic with original signature and stamp of the Kuwaiti Visa sponsor (individual information must be typewritten, handwritten entries will not be accepted).

Original and valid J-2 Pass issued by the Ministry of Defense J-2 Office (J-2 passes with date of issue within ninety (90) days of applying for installation access may not require a Background Check with KCID).

Two sponsor letters, one in English and one in Arabic, from the original Kuwaiti sponsor as listed on the Visa 18, typed on company letterhead with the following information (refer to example sponsor letter):

Authorizing work on Camp ___________ (list specific location(s)).

Applicants full name (as it appears on passport).

Kuwait Civil Identification number.

Nationality.

Visa Type.

U.S. Army Contract number and expiration date.

Type of work to be performed.

Length of time the employee requires access.

Acknowledgement that the sponsor accepts responsibility for the employee actions and conduct while on ASG-KU Installations.

Original signature and company stamp. Only one employee per letter.

Copy of Kuwait Chamber of Commerce and Industry (KCCI) Registration form must be attached to verify the authorized Sponsor and /or Company signature.

Copy of Kuwait or GCC Driver’s License if requesting Vehicle Privileges. IAW with Kuwait Common Law, those persons with Kuwait residency must have a Kuwait or GCC DL.

Foreign National employees working for a contractor other than their original Visa sponsor must also provide:

Two additional letters from the company with the Army contract, typed on company letterhead: (1) Arabic, (1) English listing all of the above information with original signature and company stamp of the Kuwaiti contractor. Only one employee per letter.

NOTE: These forms must be signed by the Kuwaiti Sponsor and/or Contractor. KCID rejects forms signed by anyone other than a Kuwaiti

Sponsor or his designate registered with the Kuwait Chamber of Commerce and Industry.

6. Department of State or U.S. Embassy Personnel (Not to include locally employed staff members, ‘Red Badge’ Holders, see below): Those personnel assigned to the United States Department of State, the U.S. Embassy Kuwait or in U.S. Diplomatic or consular posts and approved by ASG-KU Commander are required to provide the following documentation:

ASG-KU PMO Form 190-16.01.

Copy of U.S. Embassy badge or CAC (whichever applies).

Copy of Driver’s License if Vehicle Privileges are requested. Those persons with Kuwait residency must have a Kuwait DL. U.S. Driver’s License may be used only if the applicant is not required to obtain residency.

7. U.S. Embassy Locally Employed Staff Members (‘Embassy Red Badge Holders’): Those locally employed personnel assigned to the United States Department of State, the U.S. Embassy Kuwait or in U.S. Diplomatic or consular posts and approved by ASG-KU Commander are required to provide the following documentation:

ASG-KU PMO Form 190-16.01.

Copy of U.S. Embassy badge.

Copy of passport photo and data pages.

LOA, LOI, or Travel Orders.

Copy of Driver’s License if Vehicle Privileges are requested. Those persons with Kuwait residency must have a Kuwait DL.

Individuals will receive an ‘ASG-KU Commander’s Exception’ DoD IA card without an Exception to Policy Form (Unless from a Country of Concern).

8. Host Nation Government Agency:

Kuwaiti citizens:

ASG-KU PMO Form 190-16.01, completed and signed by Requesting Authority.

Original Kuwait Civil ID must be presented at the time of badging.

Copy of Kuwait Civil ID (front and back).

Copy of Kuwait Driver’s License if Vehicle Privileges are requested.

S-5/Host Nation Affairs or other authorized approval authority must verify the application.

NOTE: May require approval from KCID prior to IA Card issue (unless applicant has copy of Government ID).

FN employed by HN Government (Must have Visa 17):

Original Kuwait Civil ID must be presented at the time of badging.

Copy of passport photo, data and residency pages.

Copy of Civil ID (front and back). If Available.

S-5/Host Nation Affairs or other authorized approval authority must verify the application.

Copy of Kuwait or GCC driver’s license if Vehicle Privileges are requested.

NOTE: May require approval from KCID prior to IA Card issue (unless applicant has copy of Government ID).

9. Host Nation / GCC Contractors (must be citizens of Kuwait, Qatar, UAE, Oman, Saudi Arabia or Bahrain):

Original Kuwait/GCC Civil ID must be presented at the time of badging.

Copy of Kuwait/GCC Civil ID (front and back).

LOA/LOI on Company letterhead typed in English requesting access (refer to LOA/LOI example).

Two sponsor letters, one in English and one in Arabic, from the original Kuwaiti sponsor as listed on the Visa 18, typed on company letterhead (if applicable).

Copy of the Kuwait Chamber of Commerce and Industry Registration Form (KCCI) Registration form must be attached to verify the authorized Sponsor and /or Company signature.

Kuwait CID Cover Letter typed in Arabic with original signature and stamp of the Kuwaiti Visa sponsor (individual information must be typewritten, handwritten entries will not be accepted).

Copy of Kuwait or GCC driver’s license if Vehicle Privileges are requested.

NOTE: These forms must be signed by the Kuwaiti Sponsor and/or Contractor. KCID rejects forms signed by anyone other than a Kuwaiti

Sponsor or his designate registered with the Kuwait Chamber of Commerce and Industry.

10a. Escorted Access List (EAL) – Turn in minimum 72 hrs in advance for processing:

ASG-KU PMO Form 190-16.01, completed and signed by the Requesting Authority.

Copy of passport photo and data pages.

Copy of Driver’s License if Vehicle Privileges are requested. Those persons with Kuwait residency must have a Kuwait DL. Individuals not required to obtain residency will be allowed to use their Home of Record driver’s license.

****NOTE: Those with an expiring IA badge will not be placed on an EAL****

- WITH EITHER -

Copy of Kuwait entry stamp from passport or the entry Visa.

- OR -

Copy of Kuwait Civil ID (front and back) and residency Visa from Passport.

10b. Escorted Access for those requiring PSB to issue CAC/ Command Sponsored Dependant IDs (Escorted Access paperwork NOT required):

If individual is in the Contractor Validation System (CVS without a DD Form 1172-2), a representative/supervisor with Escort Privileges must accompany the individual to the PSB upon approval from the PM/Designate.

- OR -

For family members/dependants, the Sponsor must be present and have valid Access Media for ASG-KU Installations.

Original and copy of passport photo, data, visa pages (copies are for PSB). Copy of orders stating family members are command sponsored.

11. U.S. Citizens – USG Contractor CAC holders on TDY: Personnel will receive an Unescorted Access Memo from the PMO to access ASG-KU Installations. Access on this memo cannot exceed ninety (90) days within a 365 day period from date of initial request. Individual’s COR/DoD Representative (U.S. Military or Service Civilian) may validate Unescorted access for one (1) day only to complete processing.

Original passport and CAC must be presented at time of first entry.

Copy of passport photo, data and Kuwait entry visa pages.

Copy of CAC (front only).

Copy of SPOT LOA, LOI or Travel Orders.

Enclosure 7 (Contractor Validation Letter) signed by COR, if requesting access to SPOD or Khabari Crossing.

Copy of valid of U.S. or International driver’s license (if requesting Vehicle Privileges).

****NOTE: Expiring IA badge holders will not be placed on a CAC TDY Status****

12. Badge Upgrade (may be done unless within 45 days of Badge Expiration):

Vehicle Upgrade:

ASG-KU PMO Form 190-16.01, completed and signed by Requesting Authority (justification is required if requesting ‘Delta Access’).

Original passport must be presented at time of badging.

Copy of Valid Driver’s License

Escort Upgrade:

ASG-KU PMO Form 190-16.01, completed and signed by Requesting Authority (justification is required).

Original passport must be presented at time of badging.

Additional Camps Upgrade:

Original passport must be presented at time of badging.

LOA for specified camps.

Enclosure 7 complete and signed by the Directorate/COR (if requesting SPOD or Khabari Crossing).

FNs must provide two sponsor letters as specified in Para. 7 above.

Force Protection Condition (FPCON) ‘DELTA’ Access (Personal) Upgrade ASG-KU PMO Form 190-16.01, completed and signed by Requesting Authority (justification is required).

Original passport must be presented at time of badging.

13. Khabari Crossing & SPOD Access: Contractors who have a valid need to access the Khabari Crossing Installation (NOT required if contractor only needs access to U.S. Border Crossing) or the SPOD must provide Enclosure 7 – Contractor Validation Letter in their application packet.

Enclosure 7 must have the minimum listed:

Individual’s name.

Passport or Civil ID Number.

Contracting Company Name (CSA, ITT, etc.).

Must state ‘Khabari Crossing’ and/or ‘SPOD’ specifically (other ASG-KU Installations do not require Enclosure 7).

Contract Number.

Must be signed by an Authorized COR.

14. UNAMI: UNAMI employees must possess either a Kuwait Visa 17, 18 or 24 and provide the following documentation. IA card may not be issued without a signed exception (ASG-KU PMO Form 190-16.13) from the ASG –KU PM or higher.

Kuwait Residency – Visa 17, 18 and 24

Original Passport must be presented at the time of badging.

Copy of passport picture, data and residency pages attached to the application.

Copy of UNAMI badge (front and back).

Copy of Civil ID (front and back). If Available.

Kuwait CID Cover Letter typed in Arabic with original signature and stamp of the UNAMI representative.

Two sponsor letters from UNAMI, one in English and one in Arabic, from the original Kuwaiti sponsor as listed on the Visa 18, typed on company letterhead with the following information (refer to example sponsor letter):

Authorizing work in both Kuwait and Iraq using the U.S. Border Crossing (if applicable).

Applicants full name (as it appears on passport).

Kuwait Civil Identification number.

Nationality.

Visa Type.

U.S. Army Contract number and expiration date.

Type of work to be performed.

Length of time the employee requires access.

Acknowledgement that the sponsor accepts responsibility for the employee actions and conduct while on ASG-KU Installations.

Original signature and company stamp. Only one employee per letter.

Copy of the Kuwait Chamber of Commerce and Industry Registration form must be attached to verify the authorized company signature.

Applicants that require Vehicle Privileges must provide a copy or their Kuwaiti or GCC Driver’s License. No other license is accepted.

15. U.S. Border Crossing Only: Contractors must possess either a Kuwait Visa 17, 18 or Multi-entry Visa and provide the following documentation. ‘U.S.

Border Crossing’ must be stated specifically on all documents to be issued this badge.

Kuwait Residency – Visa 17 or 18 Refer to Para. 1, 3 or 4 depending on status.

Multi-Entry Visa ASG-KU PMO Form 190-16.01, completed and signed by Requesting Authority.

Original Passport must be presented at the time of badging.

Copy of passport picture, data and visa page attached to the application.

Copy of CAC (front and back) or MNFI badge if applicable.

LOA / LOI, Orders or Contract with the following information:

Authorizing access to Kuwait and Iraq or the specific area. If the sponsor letter states Camps or location in Iraq then Border Crossing is authorized.

Applicants name U.S. Army, U.S. Government or Coalition Contract number and expiration date.

Dates of access, Length of orders, contract etc.

Applicants that require Vehicle Privileges (drivers) must provide a copy or their Driver’s License.

16. Lost/Stolen IA card: Must be reported to the MP Desk and the Installation Access Office IMMEDIATELY.

Copy of the applicant’s Lost IA card Report (DA Form 2823 – Sworn Statement) cleared by the MP Desk.

Individual’s Access will be put ‘on hold’ until they receive a replacement IA card. Individual will be issued a Temporary Access Badge (Unescorted) for one (1) day only to process the paperwork and receive a new IA card.

Passport or Kuwait Civil ID will be required for identity verification and exchange.

17. Vehicle Registration:

TMP/GOV (Vehicles issued from the TMP):

ASG-KU PMO Form 190-16.2, Vehicle Registration Application (must be signed by Requesting Authority if a Contractor).

Original vehicle registration card.

Original authorized driver’s license (if applicable).

Contractor (including Vendors):

ASG-KU PMO Form 190-16.2 Vehicle Registration Application completed and signed by Requesting Authority.

Original vehicle registration card.

Copy of vehicle registration card.

Copy of Lease/Rental Agreement or separate copy of Insurance (unless vehicle is more than 5 years old or Vehicle Registration expiration is less than 13 months).

Copy of authorized driver’s license (all driver’s listed on application).

Copy of ASG-KU IA card, CAC, passport or Civil ID, depending on status.

Original Company Letter authorizing the use of vehicle for business purposes (if applicable; i.e. if vehicle is leased by an individual). Must be signed by the Company Manager AND the Requesting Authority

POV (Personally Owned Vehicles):

ASG-KU PMO Form 190-16.2, Vehicle Registration Application, completed and signed by Requesting Authority (some individuals may require a recommendation/signature from their Program/Department Manager). A Red ‘POV’ Placard is still authorized for the Outer Camps and do not require an Exception to Policy; however, they will not be authorized for access to Camp Arifjan.

All POVs that need access to Camp Arifjan require ASG-KU Commander approval. (ASG-KU PMO Form 190-16.13 (Exception to Policy) signed by Requesting Authority, attached to documentation and routed through the PMO).

Original vehicle registration card.

Lease Agreement or separate copy of Insurance (unless vehicle is more than 5 years old or Vehicle Registration expiration is less than 13 months).

Copy of vehicle registration card.

Copy of authorized driver’s license.

Copy of ASG-KU IA card, CAC, passport or Civil ID, depending on status.

****NOTE: Leased/Rental vehicles are viewed as POV’s****

18. Temporary Vehicle Access:

Installation Visitor: (Individuals without an ASG-KU IA card, Bazaar, Catering, etc.). Issued for one day only after verifying registration and lease/insurance information:

Original lease/rental agreement or proof of insurance.

Original vehicle registration card.

Original authorized driver’s license.

ASG-KU PMO Form 190-16.2; Vehicle Registration Application, signed by Requesting Authority.

New Vehicle Registration. Issued for ten (10) days maximum in order to process paperwork with Directorate/COR. A onetime exception may be granted by the PMO or designated representative if more days are required.

Original lease/rental agreement

USG Contractors/Civilians with CAC on TDY. Issued for the length of the TDY Orders, not to exceed thirty (30) days (unless approved by PMO or designated representative):

Original lease/rental agreement or separate proof of insurance (unless vehicle is more than 5 years old or Vehicle Registration expiration is less than

13 months).

Original vehicle registration card.

TDY Orders/LOI/LOA

Vehicle with Repair Documents and/or Change-Out Form (windshield replacement, routine maintenance, or vehicle damage). Issued for the duration specified on documents, but not more than thirty (30) days (may be extended by PMO or designated representative):

Original Repair Document and/or Change-Out Form.

19. Additional Guidance for Exceptions to Policy:

All Exceptions to Policy (PMO Form 190-16.13) will take at least three (3) days or longer for processing depending on the authority that must sign it (i.e. ASG-KU Commander’s Exception Badge requests, Prohibited Items).

DATE:

TO: Area Support Group – Kuwait (ASG-KU)

ATTN: Provost Marshal Office/Pass & ID

This is to request authorization for the below listed vehicle(s) to be allowed access to Camp(s) [list camps required by contract].

[Contract Company Name] confirms that the vehicle(s) is/are:

Owned by our Company (registration card MUST match with Company Name)

Rented by our Company (must attach valid copy of rental agreement with Company name and vehicle details mentioned)

Leased by our Company (must attached copy of lease agreement with Company name and vehicle details mentioned)

VEHICLE DETAILS:

License Plate # VIN # Manufacture

Name Model Name Model Year

AUTHORIZED DRIVER(S):

Last Name First Name Access Media # Driver’s License #

1.) Primary Contract Company:

2.) Subcontract Company (if Applicable):

I hereby confirm that the above listed vehicle(s) are not privately owned, rented or leased (POV), are either Company owned, rented or leased and are authorized access to ASG-KU Installations according to the contract.

Requesting Authority (COR) (Please ensure that the Signature Block includes Full Name, Rank/Grade, Unit/Organization, Signature and Date)

ASG-KU VEHICLE REGISTRATION APPLICATION

SECTION I – VEHICLE INFORMATION

Type of Access:

Escorted New Registration Renewal of Registration Upgrade/Additional Driver Damaged/Lost Barcode or Placard

Vehicle Identification Number (17 digit number):

Vehicle Classification:

GOV/TMP CO O/L POV VENDOR

License Plate Number:

Body Type:

Expiration of Registration (DD/MMM/YYYY):

Manufacturer Name:

Color:

Name of Rental/Leasing Company:

Model Name:

Condition of Vehicle:

New Used

Name of Insurance Company:

Year of Model:

State/Country:

KUWAIT

Expiration of Insurance:

SECTION II – DRIVER INFORMATION

Owner of Vehicle or Primary Driver Last Name:

First, Middle Name:

Date of Birth:

Kuwait Civil ID Number/Passport Number:

Social Security Number:

Driver’s License Number:

Additional Driver

SECTION III – DIRECTORATE/COR RECOMMENDATION

Vehicle Access in Force Protection Condition: Initials:

Charlie Delta

DIRECTORATE/COR RECOMMENDATION

I certify that the applicant requires vehicle access to any ASG-KU Installation. I have verified the required Vehicle and Operator documentation, assigned the vehicle FPCON and provided a written justification for those who exceed there level of access.

Telephone Number:

(965)-9973-0344 Vehicle Access Expiration Date: Initials:

30 JUNE 2013

Rank and Last Name:

GS-12, POTASI

Remarks:

Please Grant Access Per Operational Requirements For Contract #39-2604

Unit, Title, and Organization:

DLA Disposition Services, Kuwait, DLA Disposition Services Kuwait Chief, DLA

PENIAMINA F.

Signature:

ASG-KU PMO FORM 190-16.2 (01 FEB 2012) – ENCLOSURE 4

SECTION IV – MOTOR VEHICLE OPERATOR ACKNOWEDGEMENT

Data Required by the Privacy Act of 1974 (5 U.S. CODE 552a)

AUTHORITY: DoD Directive 5200.8 Security of DoD Installation and Resources, AR 190-5 Motor Vehicle Traffic Supervision, CENTCOM OPORD 10-05 Antiterrorism and the ASG-KU Installation Access Policy.

PRINCIPAL PURPOSE: To establish positive identification of vehicles authorized to access ASG-KU Installations. ASG-KU requires that all Non-Tactical Vehicles be registered and authorized prior to entry.

MADATORY DISCLOSURE REQUIREMENT: Failure to provide the required information, including social security number, passport number, Kuwait Civil Identification number, or drivers license will result in disapproval of this application. Disapproved applicants will be denied the privilege of Vehicle access onto ASG-KU Installations.

Acknowledgement of ASG-KU Installation Motor Vehicle Operator Responsibilities

As a ASG-KU Installation Motor Vehicle Operator, I acknowledge the following:

1. I understand that upon entering, exiting or while on any ASG-KU Installation the Vehicle including all contents is subject to search at the discretion of the U.S. Government, its designate or the issuing agency.

2. While on post I am responsible for displaying the License Plate Placard so it is clearly visible.

3. I am responsible for removing the Vehicle Registration tag and License Plate Placard should I sell, exchange, return or otherwise no longer have possession of the vehicle and return to the Installation

Access Office.

4. I understand that I must have a valid driver’s license, valid registration, and insurance and meet all vehicle safety requirements for entry onto ASG-KU Installations.

5. If my vehicle is stolen I must immediately notify either the MP Station or Installation Access Office.

6. I acknowledge by my signature that I have read and understand the policy, requirements, and responsibilities above.

(Print) Last, First, MI: Signature: Date:

SECTION V - PMO OFFICE USE ONLY

Vehicle/Application Inspected by: Approved FPCON: Name of person entering data:

Verifying documents enclosed Copy of Vehicle Registration Copy of Driver’s License from each Driver Copy of Civil ID or ASG-KU ID from each Driver Copy of Vehicle Insurance

Name: Vehicle Barcode Number:

Signature: DBIDS File Number of Primary Driver:

Remarks

ASG-KU PMO FORM 190-16.2 (01 FEB 2012) – ENCLOSURE 4