Fillable Printable Restricted Area Visitor Register
Fillable Printable Restricted Area Visitor Register
Restricted Area Visitor Register
ORGANIZATION
YEAR
(YYYYMMDD)
RESTRICTED AREA VISITOR REGISTER
For use of this form, see TB-380-41; the proponent agency is CSLA.
PRIVACY ACT STATEMENT
AUTHORITY
PRINCIPAL PURPOSE:
ROUTINE USES:
DISCLOSURE:
5 U.S.C. 301, Department Regulations, 10 U.S.C. 3013, Secretary of the Army, AR 190-16, Physical Security; TB-380-41 and EO 9397 (SSN).
This information will be used to verify the identity of visitors into controlled access areas.
None. The "Blanket Routine Uses" set forth at the beginning of the Army's Compilations of System of Records Notices apply to this system.
Voluntary. However, failure to provide all the requested information may result in denial of access to the controlled areas.
REQUIREMENT CONTROL
SYMBOL: AMC-226 (Ri)
DATE
PURPOSE
OF VISIT
CLEAR-
ANCE
STATUS
(TS, S,
Conf, None)
MATERIAL
STORED OR
SCREENED
DAY
PRINTED NAME
(First, MI, Last)
GRADE SSN SIGNATURE
AUTHORIZING
OFFICER'S
SIGNATURE
TIME
ORGANIZATION
IN OUT
DA FORM 1999, MAR 2006
APD LC v1.00
YES NO
MO
EDITION OF JAN 1988 IS OBSOLETE.
FOR OFFICIAL USE ONLY WHEN FILLED IN.
FOR OFFICIAL USE ONLY WHEN FILLED IN.
