Get AFMC 496 2003-2024

NAME/TITLE BUSINESS ADDRESS OR ORGANIZATION/SYMBOL SIGNATURE AFMC FORM 496 20030314 IMT-V1 PREVIOUS EDITION IS OBSOLETE DATE MS. This is a web-optimized version of this form* Download the original full version www. usa-federal-forms. com/download*html Convert any form into fillable savable www. fillable. com Learn how to use fillable savable forms Demos www. fillable. com/demos. html Examples www. fillable. com/examples. html Browse/search 10 s of 1000 s of U*S* federal forms converted into fillable savable APPLICATION FOR AFMC IDENTIFICATION CARD This Form Is Subject to the Privacy Act of 1974 PRIVACY ACT STATEMENT AUTHORITY Title USC Section 301 Departmental Regulation* PRINCIPAL PURPOSE To implement AFI31-101 The Air Force Installation Security Program* ROUTINE USE To request and record the issuance of AFMC Form 387 Air Force Materiel Command Identification Card and to request and record issuance of any identification credential when the use of another form has not been specified* DISCLOSURE Information requested on the form is mandatory. Failure to provide any of the requested information will result in non-issuance of AFMC identification credentials. I hereby acknowledge receipt of the credentials indicated by my signature below and am fully aware of my responsibilities pertaining to their use. I will promptly return all credentials when they are not needed for my assigned duties or upon requested by proper authority. NOTICE While on this installation all personnel and the property under their control are subject to search. Controlled radioactive material being brought onto an AFMC installation must first be approved by the monitor for nuclear safety. TO FROM Business Address or Orgn/ Symbol/Sponsor of Prime Contractor NAME MILITARY GRADE LOCAL BUSINESS ADDRESS OR SUB-CONTRACTOR/PHONE SSN MR* PLACE OF BIRTH DATE OF BIRTH CITIZEN Country WEIGHT HAIR HOME ADDRESS CONTRACTOR EYES PHONE GOVERNMENT EMPLOYEE ISSUE DATE CARD NUMBER Locally Assigned OTHER CONTRACT NUMBER CARD EXPIRATION SIGNATURE OF RECIPIENT SIGNATURE OF ISSUING REMARKS CERTIFICATE OF REQUESTING OFFICIAL I certify that the applicant has an official/authorized need for the credential requested and has been briefed on its proper use. This is a web-optimized version of this form* Download the original full version www. usa-federal-forms. com/download*html Convert any form into fillable savable www. fillable. com Learn how to use fillable savable forms Demos www. com/download*html Convert any form into fillable savable www. fillable. com Learn how to use fillable savable forms Demos www. fillable. com/demos. html Examples www. fillable. com/examples. html Browse/search 10 s of 1000 s of U*S* federal forms converted into fillable savable APPLICATION FOR AFMC IDENTIFICATION CARD This Form Is Subject to the Privacy Act of 1974 PRIVACY ACT STATEMENT AUTHORITY Title USC Section 301 Departmental Regulation* PRINCIPAL PURPOSE To implement AFI31-101 The Air Force Installation Security Program* ROUTINE USE To request and record the issuance of AFMC Form 387 Air Force Materiel Command Identification Card and to request and record issuance of any identification credential when the use of another form has not been specified* DISCLOSURE Information requested on the form is mandatory. .