ENTRY_Access_List_Form_for_Site_Visit_ _Directions.pdf

Last Name First Name Number State Start End Name Phone 1 14-Jan-00 Uly Gomez 634-2920 Corps Engrs Trailer/B2541 Power Pro Shop

EAL Form v2 9 SFS, Beale AFB, CA 95903

“This electronic transmission contains FOR OFFICIAL USE ONLY (FOUO) information that must be protected under the Privacy Act of 1974 (see AFI 33- 332). Do not release outside of DoD channels without the consent of the originator’s office."

Purpose of Form: Use Form Entry Access List (EAL) Form v1 to apply for clearance to enter Beale Air Force Base, California .Who must Apply: Any individual who is not eligible to obtain a Department of Defense (DoD) identification .How to Apply: Type the data requested in the form for each company member . Company name and address must be included.

NOTE: EAL must be submitted by military point of contact and hand written submittals will not be processed. DISCLOSURE: All information will be used to verify identity and a criminal history check will be conducted. You are voluntarily submitting your information for this purpose. Your information will be protected IAW the Privacy Act of 1947.

Company Name Address:

Birth DateVisitor's Name SponsorAccess DatesDriver License# Destination

ENTRY ACESS LIST FORM