NFPC_VISITOR_DATA_REQUEST_FORM.pdf

Requests may be submitted to USFF_NNSY_PNBC_PHILLY_NFPC‐Security@navy.mil or may be faxed to 215‐897‐3320.

NFPC VISITOR DATA REQUEST FORM

Date of Request:_________________

VISITORS FULL NAME (First, Middle, Last)

GENDER

FULL SOCIAL SECURITY NUMBER

COUNTRY OF ORIGIN/CITZENSHIP

DATE OF BIRTH (MM/DD/YYYY)

PLACE OF BIRTH (city and country)

RACE

SECURITY CLEARANCE (Date and granting authority)

VISITOR ORGANIZATION/EMPLOYER

MEETING START DATE AND TIME

MEETING ENDING DATE AND TIME

PURPOSE OF MEETING

Next section for NFPC use only

BUILDING(S) & ROOM NUMBER(S) TO BE

VISITED

WILL CRITICAL INFRASTRUCTURE

AND/OR SENSITIVE WORK AREAS BE

VISITED?

HOSTING OFFICIAL (name, title, code, office/bldg, room number, and phone number)

ESCORT INFORMATION (If different from Hosting Official)

JPAS:

Pass Issued, #, Expiration date: