AUTHORITY: Executive Order 10450; and Public Law 99-474, the Computer Fraud and Abuse Act 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin with Part I. Fill in your name, organization, office symbol, phone number, official email address, job title and grade/rank, official mailing address, citizenship status, designation of person (military/civilian/contractor), and IA training certification.
  3. In Part II, provide justification for access and select the type of access requested. Ensure you specify if access is needed for unclassified or classified information.
  4. Complete the supervisor endorsement section by entering the supervisor's name, email address, phone number, organization/department, and signature.
  5. Proceed to Part III for security manager validation. Fill in details regarding the type of investigation and verification by the security manager.
  6. Finally, review all sections for accuracy before submitting your completed form electronically through our platform.

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Executive Order 10450 (PDF), Security Requirements for Government Employment, April 27, 1953 Requires that all persons employed in Government departments and agencies be reliable, trustworthy, of good conduct and character, and of complete and unswerving loyalty to the United States.