Visitor Request Form.pdf

PDF 94 KB Posted Aug 12, 2025

Attached to: Fitness Equipment Maintenance and Repair
Solicitation number: FA286025Q4033
Issued by: Department of the Air Force Headquarters District Washington

About this file

Written by GovTribe AI · Aug 12, 2025

This document is an Unofficial Visitor Base Pass Request form from the 316th Security Support Squadron/Visitor Control Center, revised on 28 Sep 2022. The form is designed for military or civilian sponsors to request base access for visitors, with specific guidelines for submission. Key requirements include delivering the form 72 hours prior to the visit via email, consenting to a background check, and providing detailed visitor information such as name, date of birth, driver's license details, and purpose for base entry. The form emphasizes strict privacy and security protocols, warning that any wants and warrants will result in prosecution, and mandating that sensitive information shall not be disclosed without direct need-to-know authorization.

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1. CCH TRACKER 2. RAN BY: 3. B.A.L: ***BLOCKS 1 - 3 FOR VCC USE ONLY ***

Revised 28 Sep 2022JCH

First Name Rank

Last Name First Name MI DOB Driver's License State/Number Pass Start Date Pass End Date Purpose On Base

DO NOT SEND THIS REQUEST FORM WITH DOB AND DL NUMBER FROM A COMMERCIAL /PERSONAL EMAIL ACCOUNT (E.G. YAHOO); IF YOU CANNOT SEND FROM

GOVERNMENT EMAIL ADDRESS, PLEASE DROP OFF FORM AT VCC

IF IDENTIFICATION STATES "NOT VALID FOR FEDERAL PURPOSES," "NOT FOR USE AS FEDERAL IDENTIFICATION," "FEDERAL LIMITS APPLY" OR ANY OTHER SIMILAR PHRASE, A US PASSPORT OR BIRTH CERTIFICATE AND SOCIAL SECURITY CARD IN CONJUNCTION WITH YOUR CURRENT ID WILL BE REQUIRED.

PRIVACY ACT 1974 - CONTENTS SHALL NOT BE DISCLOSED, DISCUSSED, OR SHARED WITH INDIVIDUALS UNLESS THEY HAVE DIRECT NEED-TO-KNOW IN THE PERFORMANCE OF THEIR OFFICIAL DUTIES. DELIVER THIS DOCUMENT DIRECTLY TO THE INTEDED RECIPIENT. DO NOT DROP OFF WITH A THIRD PARTY

MUST BE DELIVERED 72 HOURS PRIOR IF BEING SENT BY EMAIL

ALL VISITORS ON THIS FORM ARE CONSENTING TO A BACKGROUND CHECK

IF ANY WANTS AND WARRANTS ARE FOUND THEY WILL BE PROSECUTED ACCORDINGLY

Last Name E-Mail Address Contact Number

Visitor Information

Military / Civilian Sponsor Information

316th Security Support Squadron/Visitor Control Center

Unofficial Visitor Base Pass Request

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SPONSOR LAST: Shorter

SPONSOR EMAIL: damian.shorter.2@us.af.mil

SPONSOR FIRST: Damian

SPONSOR CONTACT:

SPONSOR RANK: Civ

File details come from the government source that posted it. Updated Aug 12, 2025.