T8 B5 Miscellaneous Fdr- 4 Authorization Forms for NMCC Visits

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COMMUNICATION

RESULT

REPORT

(

JUL.

15.

2003

12:47PM

)

x

FAX

HEADER

1:

9-11

COMMISSION

FAX

HEADER

2:

LWJSISMITTED/STORED :

JUL.

15.

2003

12:46PM

MODE OPTION

ADDRESSRESULT

OK

PAGE

4/4

EMORY

TX917036979028

REASON FOR

ERROR

E

— 1

HANG

UP OR

LINE

FAIL

£

—

3)

NO ANSWER

Thomas H.

CHAIR

Lee H.

Hamlton

VICE

CHAIR

Richsird

Ben-Vcniste

Fi

Fielding

Jamie S.

Gorelick

Slade

OortonJohn

X-chmstn

Timoii>yJ

Roemer

James

R.

ThompsonPhilip

D.

Zelikerw

EXECUTIVE

DIRECTOH

FAX

COVER SHEET

To:

From

t~-~

~

Date:

*~f

/

('^''tf

/

O

J

Number

of

pages (including cover

sheest):

TSL

(3O2)

331-4060

FAX

(202)

296-5345

.9-11commssion.gov

9/11

Law

^r.

or

cement Sensitive

CM

SI

O

JOINT STAFF

TEMPORARY

RES'.

DTED

AREA ACCESS

REQUEST

'

(ESCORT REQUIRED)

p

(£

£^

7d

>3^f

?

-

?Q

^

1. This

form

is used (or

visiting personnel

who

require

temporaryaccess

(less

than 30

days)

to the

Joint

Staff Restricted Area,

and who DO NOT

possess

a TOP

SECRET security clearance.

<r

H

o

2.

Location

of

visit:

3.

Date(s)

of

Visit:

17

Ju

4.

Affected

Guard

Posts:

9,16,17

and

la

5.

Visiting

Personnel:

(PERSONNEL LISTED

MUST BE

ESCORTED

AT ALL

TIMES)

Starting

Time:

13QQ

Local

Ending

Time:

JS

Sponsors

Name

&

Phone

Number:

coi

Kuehi

/[__

Name

Of Escort Official

Lt

Col Rezzonico/ Haj

Carter

150

°

Local

to

n

Jui

03

<

For NMCC

Entry Only)

NAME:

(Last,

First,

Ml)

SSAN:

RANK/SERV:

•DPOB: (Date/Place

of

Birth)•CITIZENSHIP:

HiWs

c/

7 A

6.

Approval

of the

NMCS

OPS^NG

BR, for

NMCC

entry:

7. Approved by: i

(JS

Security

Division)

NOTE:

Additionalnames

may be

added

by

attaching

a

plain

pieceof

bond

paper to

this

form.*

DPOB

&

Citizenship

blocks

must

be completed for

civilians,

PRIVACY

ACT

STATEMENT

AUTHORITY:

Title

10,

U.S. Code, Chapter

5,

Section 151-155, arid

E.0.

9397.

PRINCIPALPURPOSE:

To maintain a record of non-Joint

Staff

assigned persons having access to the Joint

Staff

Restricted Area.

ROUTINE USES:

Nona.

DISCLOSURE:

Failure to disclose

requested

data could result In

denial

of

access

to the Joint

Staff

Restricted

Area.

JSFORM5AOCT92(EF)

PREVIOUS

EDITION

IS OBSOLETE

9/11 Personal Privacy

9/11 Closed by Statute

1

JOINT

STAFF

TEMPORARY

RES

DIED

AREA ACCESS REQUEST

(ESCORT

REQUIRED)

1. This form

is

used

for

visiting

personnel

who

require temporary access (less than

30

days)

to the

Joint Staff Restricted Area,and who

DO

NOT possess a TOP SECRET security clearance.

(PERSONNEL

LISTED MUST

BE

ESCORTED

AT ALL TIMES1

2.

Location

of

visit:

mcc

Starting

Time:

13QQ

Local

Ending Time:

I50

°

Local

*/

I

1

JS

Sponsors

Name

&

Phone

Number:

Col

Kuehi

/

| |

Name

of

Escort

Official

Lt

ColRe2zonico/Maj

Carter

3.

Date(s)

ol

Visit:

21

jui

03

to

21

Jui

4.

Affected Guard

Posts:

9,16,17

and 18

5.

Visiting Personnel:(For NMCC

Entry

Only)

NAME:

(Last,First,

Ml)

SSAN:

RANK/SERV:

*DPOB:

(Date/Place of Birth)

'CITIZENSHIP:

jnt'U*

'

It

US

6.

Approval of the

NMCS

OPS/TNG

BR, for NMCC entry:7.Approvedby:

(JS Security

Division)

NOTE:

Additional

names

may beaddedby

attaching

a

plain

piece

ofbond

paper

to

this

form.*DPOB

&

Citizenship

blocks

must

be

completed

for

civilians.

PRIVACY ACT

STATEMENT

AUTHORITY:

Title

10, U.S. Code, Chapter

5,

Section

151-155,

arid

E.O. 9397.

PRINCIPAL PURPOSE:

To maintain

a

record

of

non-Joint

Staff

assigned

persons

having

access to the

Join!

Staff

Restricted Area.

ROUTINE USES:

None.

DISCLOSURE:

Failure to disclose requested data couldresultIn denial of access to the Joint

Staff

Restricted Area.

JS FORM 5A OCT

92

(EF)

PREVIOUS

EDITION IS OBSOLETE

9/11 Personal Privacy

of 00

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