Instructions For U-1201 - Request For Visit (Rfv) Form

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INSTRUCTIONS FOR U-1201
REQUEST FOR VISIT (RFV) FORM
The following form must be completed in full. Failure to complete all areas of the form will
result in the Request For Visit (RFV) being rejected.
A. GENERAL INSTRUCTIONS
1. DSS requires five (5) business days as lead time for processing RFV requests. This
is in addition to each country’s lead time requirement for approval review.
2. Duration of a visit may not be longer than 364 days (one year, less one day).
B. SPECIFIC INSTRUCTIONS
Top of
Mark ONE box which best describes the type of visit – One-Time, Recurring, etc.
Form
Advise if Annexes are included – Mark appropriate box YES or NO.
(Annexes refer to the last two pages of the form, which provide overflow space to
accommodate additional sites to be visited, and/or additional visitors.)
Block 1
For Government use only. Leave blank.
Block 2
Provide facility CAGE (Commercial And Government Entity) Code in addition to
requesting company’s facility address.
Block 3
If more than one site is to be visited, additional sites can be documented on page 3
(referred to as Annex 1). Ensure the complete site Point of Contact information
is provided.
Block 4
Duration of a visit may not be longer than 364 days (one year, less one day).
Format for dates should be as follows: Day Month Year (e.g. 05 May 2013),
with the month spelled out.
With regards to Emergency Visits, exact dates must be cited, plus the visit duration
can be no longer than 30 days.
Block 5
TWO selections are required. One from left and one from right column.
Block 6
Explain the subject to be discussed in detail. Vague descriptions such as “technical
discussions” or “technical interchange meeting” for example, are not sufficient.
Block 7
Indicate classification level of visit – Confidential, Secret, Top Secret, or
Classified Site.
Block 8
Check appropriate block, and specify the current Contract Number/Project/Program
Name on the corresponding line.
Block 9
If the space allotted in block 9 cannot accommodate the number of intended visitors:
1. Scroll down to page 4 (referred to as Annex 2).
2. Include additional visitors as needed.
Block 10
Facility Security Officer’s name and contact numbers. Note: This visit request is NOT
valid without the company security officer or Facility Security Officer’s signature.
Block 11
For Government Use Only.
Block 12
For Government Use Only.
Block 13
This area provides additional writing space for blocks above with insufficient space.
Upon completion, fax form to DSS International Division at (571) 305-6010,
ATTN: International.

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