BasePassRequest_(003).docx
DOCX document 28 KB Posted
- Solicitation number
- W912GB18R0031
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Base Pass Request
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Date: ______________ From: ________________SUPPLY/FUELS__________________________________________________ (Tenant Command or NAVSTA Department requesting base pass)
| To: | Jefatura de Seguridad, Base Naval de Rota (Spanish Security Officer) | ||
| Via: | Security Officer, U.S. Naval Station, Rota, Spain | ||
| Subj: | REQUEST FOR WORK PASS | INITIAL ISSUE | RENEWAL (Check one ) |
| Ref: | (a) Spanish Navy Norma General 02/93 9Base Access Procedures) |
1. Base on the following information, I request that a work pass be issued to the persons listed below: ( Check type of pass )
| -Contractor Employee | -Shipping Agent | -Domestic Servant | |||
| (Complete a thru h) | (complete a thru d and g) | (Complete a, b, c, e, h and i) | |||
| -Technical Expert | -Business Visit (One day only) | ||||
| (Complete a thru d) | (complete a thru d) |
a. Duration of the pass: _ _____________ (Specify period of time: days of the week, and hours of work)
b. Job to be performed: __ ___________________________ _______________
c. Job location: ______________ ___________________________________________ ____
d. Company/employer’s name & address: _______ ___________________________ ___________________
e. Sponsor’s name/rank/phone: ______Kevin J. Pinneo, GS-11, FLCSI-Rota 727 4934______________________________
f. Attach copy of work/service contract; job order/request for services
g. Attach current Social Security documents.
h. Attach photocopy of Spanish ID/Passport
i. Attach medical certificate from base hospital.
Individual’s Full Name ID. Card/Passport Nationality
| __________________________________ | _________________________________________________________ | ||
| (Signature of Security Officer) | (Signature of CO, OIC, Dept. Head or authorized Representative) | ||
| IMPORTANT: | CHECK WITH PASS CLERK OR CALL EXT. 3247 IN CASE OF DOUBT | PASS REQUEST MUST BE COMPLETED IN DUPLICATE. |
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