Va Form 8824i - Caats Contractor Access Request Form

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CAATS CONTRACTOR ACCESS REQUEST FORM
PRIVACY ACT STATEMENT: The information is solicited under authority of Title 38, United States Code and Executive Order 9397 and is necessary
to accomplish the action requested by the requester, including establishing, modifying or deleting a Network Resources Customer Account. Furnishing
the information on this form is voluntary; however, if the information is not furnished, we will be unable to take further action on your request.
1. ACTION REQUESTED (Check only one)
MODIFY EXISTING CUSTOMER
DELETE EXISTING CUSTOMER
CREATE NEW CUSTOMER
2. CUSTOMER INFORMATION
B. CAATS USER ID (Email Address)
A. FULL NAME (First Name, Last Name)
C. COMPANY
D. ADDRESS
E. CITY/STATE/ZIP
F. TELEPHONE NUMBER (Include Area Code)
G. JOB TITLE/DEPARTMENT
H. VENDOR CODE (Tax Identification Number)
SECTION A
STATION ACCESS NEEDED
OBLIGATION NUMBER/
(List all stations you need
ROLE
CONTRACT NUMBER
access to in CAATS)
INITIATOR
READ ONLY
INITIATOR
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All access requested above will require approval before action can be completed. Send this form electronically to your VR&E representative.
NOTE: Do not combine multiple staff in one email request.
3. SIGNATURES
REQUESTING OFFICIAL AND TITLE
DATE
VR&E OFFICIAL AND TITLE
DATE
CAATS APPROVING OFFICIAL AND TITLE
DATE
8824i
VA FORM
MAY 2013

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