Copy_of_DBIDS_App.xlsx
XLSX spreadsheet 17 KB Posted
- Attached to
- AASF AUDIO VISUAL REFRESH
- Solicitation number
- W912LC-14-T-0178
About this file
APPLICATION FOR SITE VISIT
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| AASF_AV_refresh_SOW_2014.docx | DOCX document |
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Text version
Sheet1 Defense Biometric Identification System Application Date received by the VC:________________
Privacy Act Statement 1974 as Amended applies - this communication contains personal information, which must be protected IAW DOD 5400.11R, AFI 33-332 and is “FOR OFFICIAL USE ONLY
Section I
Last, First MI Social Security Number Date of Birth
Weight (Lbs) Height Eye Color
Hair Color Gender Driver's License #
Home Phone Number Work Phone Number State of Issue
Address Applicant Signature Date
| (may be signed at time of card issuance) | |
| *Note: The applicant's signature indicates that he or she authorizes Law Enforcement Officials to perform National Crime Information and Colorado Crime Information Check |
Section II Sponsoring Agencies Information
Sponsoring Agency's Title (Unit, organization, or Agency) Sponsoring Agency's Phone Number Company Name
| COARNG, USPFO-CO | ||
| Purchasing and Contracting | ||
| Days Of Access | Hours Of Access | FPCON Level |
Date of Expiration (YYYY/MM/DD) Today's Date (YYYY/MM/DD)
Sponsor's Printed Name Sponsors Signature
| * Applications are valid for the duration of the contract not to exceed three years from card issue date. |
| Section III NCIC Check |
| Favorable | Date of Check: | Derogatory | |
| Authenticated By: | |||
| Printed Name | Signature |
| Issued By: | |
| Name: | Date: |
As of 2 FEB 12
Sheet2
Sheet3
File details come from the government source that posted it. Updated .