Form 2928-2025

1. Click ‘Get Form’ to open it in the editor.
2. In Part I, enter your personal information. Fill in your last name, first name, middle initial, and suffix if applicable in Block 1.
3. For Block 2, input your Social Security Number (SSN), local national number, or Status of Forces Agreement number as required.
4. In Block 3, provide your agency code and major claimant code. Refer to the DCPS User Manual for the correct codes.
5. Block 4 requires you to indicate your affiliation by marking the appropriate box and entering a country code if you are a foreign national.
6. Complete Block 5 by certifying that you have finished the DCPS Security Awareness Online Course and enter the completion date.
7. In Part II, mark all applicable database designators in Block 6 for payroll office access and provide any necessary printer ID in Block 7.
8. Fill out Blocks 8 through 11 with the appropriate action codes and authorization types based on your access needs.
9. Finally, sign and date the form in Blocks 12 and 13. Ensure your supervisor completes their section in Blocks 14a through 14d before submission.

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