Worksheet - WSF-M Overview.pdf

Are any aspects of this technology included in: U.S. Munitions List;

ITAR 22, CFR Part 121; CCL; Security Classification Guide; DD Form 254 or a Technology Protection Plan? Provide materials referenced to support the decision in block 16.

If this material results from an international agreement is the USAF authorized to release program information?

PUBLIC AFFAIRS SECURITY AND POLICY REVIEW WORKSHEET

NOTE: Public release clearance is NOT required for material presented in a closed meeting and which will not be made available to the general public, on the Internet, in print or electronic media.

1. SUBMITTER NAME OFFICE SYMBOL PHONE 2. DATE SUBMITTED

3. AUTHOR(S) NAME PHONE

4. DOCUMENT TITLE

5. DOCUMENT TYPE

ABSTRACT

SPEECH

THESIS/DISSERTATION

6. CONFERENCE/EVENT/PUBLICATION NAME

TECH REPORT

BRIEFING CHARTSTECH PAPER

VIDEOJOURNAL ARTICLE

OTHER

PHOTO

7. DATE NEEDED

8. EVENT LOCATION

10. RELATED CASES PREVIOUSLY APPROVED

11. NATIONAL SECURITY STATUTES/TECHNOLOGY ISSUES

YES

NO

a.

YES NO Does this information meet the criteria for Distribution Statement "A" - unclassifed, unlimited distribution?

b.

(If NO, please identify release authority organization)

12. RELEASE AUTHORITY/JOINT EFFORTS

YES NOa.

YES NO If this is a joint program, does your organization maintain primary management responsibility and authority to release all information?

b.

PAO SIGNATURE

9. EVENT DATE

YES NO If this information is for a Small Business Innovation Research contractor and the program manager is responsible for public release, is a waiver letter on the file granting permission to release?

c.

14. PA USE ONLY

DISAPPROVEDCLEARED AS AMENDED

DATE

NA

NA

NA

ORGANIZATION

Page 1 of 2 Pages

13. COORDINATION Indicate nonconurrence, concurrence, or concurrence "with comments" in block provided.

OFFICE PROVIDING

COORDINATION

CONCUR DATE

COORDINATORS NAME, GRADE/RANK,

OFFICE SYMBOL

COORDINATORS

SIGNATURE

CASE NUMBER

USSF Security and Policy Review Worksheet 20 December 2019

1. Submitter Name/Office/Phone: Self explanatory.

2. Date Submitted: Self explanatory.

3. Author(s) Name/Organization/Phone: List up to three authors.

4. Document Title: Self explanatory.

5. Document Type: Indicate the type of information to be reviewed.

6. Conference/Event/Publication Name: If applicable.

7. Date Needed: Allow 10 business days for review, 45 days if forwarded for further coordination/approval or is a thesis.

8. Event Location: If applicable.

9. Event Date: If applicable.

10. Related cases previously approved: If similar information has been released, provide public affairs case number, if known.

11. National Security Statutes/Technology Issues

a. See the U.S. Munitions List at http://www.access.gpo.gov/nara/cfr/waisidx_99/22cfr121_99.html; International Traffic in Arms Regulations at http://www.pmddtc.state.gov/regulations_laws/itar.html; and the Commerce Control List (CCL) at http://www.access.gpo.gov/bis/ear/ear_data.html.

Programs utilizing classification information must consult related Security Classification Guides to determine if any classified information is included in the material proposed for release.

b. Only Distribution A information will be approved for public release. Distribution A information is approved for public release; distribution is unlimited, per AFI 61-204, attachment 2.

12. Release Authority/Joint Efforts. Completed by originator based on his knowledge of the information.

13. COORDINATION:

OPSEC Coordinator: Signature certifies that the information contains no Operational Security issues. This can be signed by an OPSEC officer, OPSEC Coordinator, or supervisor of the submitter.

Security Manager: Signature certifies review by USSF/IP or security manager, and proper Security Classification Guide determination by originator.

Originator: Signature certifies that the originator verifies the information is appropriate for public release based on regulations, classification guides, any other pertinent guidance and has been routed through Security and Policy authorities as appropriate.

Final Certification: Signature certifies that the information has been reviewed by a division chief level superior of the originator and concurs the material meets requirements for public release based on regulations, classification guides, and any other pertinent guidance.

14. PA Use Only. To be completed by PA office.

15. Comments: Provide additional information as appropriate. Use a separate sheet if necessary.

INSTRUCTIONS FOR SECURITY AND POLICY REVIEW WORKSHEET

15. COMMENTS

Per Air Force policy, this document must be converted to PDF or scanned image format before distribution to the public. Inclusion of the distribution A statement, “DISTRIBUTION A: Approved for public release; distribution unlimited” is also required on the first page of this document.

Page 2 of 2 PagesUSSF Security and Policy Review Worksheet 20 December 2019

Security reviewed and approved for OPSEC concerns only; however, technical data for public release approved by the program office subject matter expert, Mr. Theodore Yun.