PSNS Security Request Forms.pdf
Posted: Aug. 3, 2026
• Type: .pdf
• Size: 1.11MB
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Summary
This **PSNS & IMF visitor-access security instruction and associated access-request forms**, issued by Puget Sound Naval Shipyard and Intermediate Maintenance Facility (PSNS & IMF), establishes documentation, vetting, dosimetry, badge, and conduct requirements for visitors seeking access to Mooring “A,” Ex-CGN-9, the Controlled Industrial Area (CIA), and other PSNS & IMF locations.
Except for active-duty military members and federal civilian employees who are exempt from the same background-check process, visitors must present a valid, current REAL ID-compliant government photo identification and original or state-certified proof of U.S. citizenship. Acceptable citizenship documents include:
- A state-issued birth certificate.
- An enhanced driver’s license issued only by Michigan, Minnesota, New York, Vermont, or Washington.
- An unexpired U.S. passport book or card.
- An original Certification of Naturalization (FS-550/560).
- An original Born-Abroad Certificate (FS-240).
Photocopies, electronic records, and hospital-issued birth records are not accepted.
Visitors must complete SECNAV 5512/1 and PSNS & IMF 5512/127 with applicable company information, password-protect the forms, and transmit them by encrypted email to the designated PSNS security recipients before arrival.
The general instruction requires submission two weeks before the visit, while the PSNS & IMF 5512/127 form states that a trusted agent must submit it seven days before the visit. The request must identify:
- The company or command.
- CAGE code.
- Address.
- Access purpose.
- Contract number, when applicable.
- Organization or shop to be visited.
- Access dates.
- Personnel names.
- SSNs.
- Requested clearances.
- Citizenship status.
- Locations.
- Badge type.
The form identifies the following badge types:
- **White badges:** Escorted access.
- **Yellow badges:** UNPI and controlled nuclear information areas.
- **Green badges:** General unclassified CIA or detachment access.
- **Red badges:** Nuclear work areas and reactor compartments.
Applicable DoD or DOE clearance and training requirements also apply.
Additional controls apply to specialized access. Non-government civilian contractors entering confined spaces must provide their own gas-free certifications and coordinate with PSNS before the visit.
Visitor dosimetry authorization must be submitted on company letterhead with the access forms two weeks before arrival. It must include each visitor’s full name, SSN, sex, date of birth, employer and contact information, visit dates, quarter-to-date, year-to-date, and lifetime exposure data, and confirmation that no known medical condition prevents exposure.
Camera phones, cameras, and other recording devices are prohibited in the PSNS CIA unless the individual has received specific PSNS Security training.
The forms also collect identity, employment, physical-description, citizenship, criminal-history, and authorization information for background checks and identity proofing, and contain CUI and Privacy Act notices.
Except for active-duty military members and federal civilian employees who are exempt from the same background-check process, visitors must present a valid, current REAL ID-compliant government photo identification and original or state-certified proof of U.S. citizenship. Acceptable citizenship documents include:
- A state-issued birth certificate.
- An enhanced driver’s license issued only by Michigan, Minnesota, New York, Vermont, or Washington.
- An unexpired U.S. passport book or card.
- An original Certification of Naturalization (FS-550/560).
- An original Born-Abroad Certificate (FS-240).
Photocopies, electronic records, and hospital-issued birth records are not accepted.
Visitors must complete SECNAV 5512/1 and PSNS & IMF 5512/127 with applicable company information, password-protect the forms, and transmit them by encrypted email to the designated PSNS security recipients before arrival.
The general instruction requires submission two weeks before the visit, while the PSNS & IMF 5512/127 form states that a trusted agent must submit it seven days before the visit. The request must identify:
- The company or command.
- CAGE code.
- Address.
- Access purpose.
- Contract number, when applicable.
- Organization or shop to be visited.
- Access dates.
- Personnel names.
- SSNs.
- Requested clearances.
- Citizenship status.
- Locations.
- Badge type.
The form identifies the following badge types:
- **White badges:** Escorted access.
- **Yellow badges:** UNPI and controlled nuclear information areas.
- **Green badges:** General unclassified CIA or detachment access.
- **Red badges:** Nuclear work areas and reactor compartments.
Applicable DoD or DOE clearance and training requirements also apply.
Additional controls apply to specialized access. Non-government civilian contractors entering confined spaces must provide their own gas-free certifications and coordinate with PSNS before the visit.
Visitor dosimetry authorization must be submitted on company letterhead with the access forms two weeks before arrival. It must include each visitor’s full name, SSN, sex, date of birth, employer and contact information, visit dates, quarter-to-date, year-to-date, and lifetime exposure data, and confirmation that no known medical condition prevents exposure.
Camera phones, cameras, and other recording devices are prohibited in the PSNS CIA unless the individual has received specific PSNS Security training.
The forms also collect identity, employment, physical-description, citizenship, criminal-history, and authorization information for background checks and identity proofing, and contain CUI and Privacy Act notices.
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