Dd Form 2929 - Defense Civilian Pay System (Dcps) Non-Payroll Office Access Form

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DEFENSE CIVILIAN PAY SYSTEM (DCPS) NON-PAYROLL OFFICE ACCESS FORM

(Block 27 continuation of DD Form 2875)

PRIVACY ACT STATEMENT

AUTHORITY: Executive Orders 10450 and 9397 (SSN), Public Law 99-474, The Computer Fraud and Abuse Act (as amended), and 18 U.S.C. Section 1030 (as amended).

PRINCIPAL PURPOSE(S): To record names, signatures, and Social Security Numbers for the purpose of validating the trustworthiness of individuals requesting access to

Department of Defense (DoD) systems and information.

ROUTINE USE(S): In addition to those disclosures generally permitted under 5 U.S.C. 552a(b) of the Privacy Act, these records or information contained therein may specifically

be disclosed outside the DoD as a routine use pursuant to 5 U.S.C. 552a(b)(3) as follows: The DoD "Blanket Routine Uses" set forth at the beginning of DoD's compilation of

systems of records notices apply to this system.

DISCLOSURE: Disclosure of this information is voluntary; however, failure to provide the requested information may impede, delay, or prevent further processing of this request.

PART I. USER PERSONAL INFORMATION (To be completed by the user, an authorized CSR, or the user's supervisor/government sponsor)

1. NAME (Last, First, Middle Initial)

2. EMPLOYEE ID

3. AGENCY/MAJOR CLAIMANT

(SSN/LN #/SOFA #)

MAJOR CLAIMANT

AGENCY CODE:

CODE:

4. AFFILIATION (If affiliation is Foreign National, provide country code)

CIVILIAN (C)

CONTRACTOR (R)

MILITARY (M)

FOREIGN NATIONAL (F)

COUNTRY CODE:

5. DCPS SECURITY AWARENESS ONLINE COURSE COMPLETION CERTIFICATION

(IMPORTANT: New users must complete this course before requesting

access)

I have completed the DCPS Security Awareness Online Course.

DATE (YYYY-MM-DD):

PART II. USER ACCESS INFORMATION (To be completed by the user, an authorized CSR, or the user's supervisor/government sponsor.)

6. DATABASE DESIGNATOR

(X all that apply for a payroll office and enter designator(s) in column 13. A different form must be submitted for each payroll office.

CPI

OMA

ZFA

ZFR

ZKA

ZKE

ZPA

ZPV

ZGT

ZLO

ZPB

ZPD

ZPH

7. HOME ACTIVITY CODE

8. SITE ACTIVITY CODE

9. SITE INDICATOR CODE

10. PRINTER ID FOR REPORTS

11.a. CSR NAME (Last, First, Middle Initial)

b. TELEPHONE NUMBER

c. EMAIL ADDRESS

: AUTHORIZATION NUMBER

(Enter in Column 16)

12. USER TYPE

Enter ONLY corresponding:

AUTHORIZATION TYPE

(X one)

(Enter in Column 15)

M - CSR MER Clerk (non-SF50)

CSR group or "All" for all groups within CSR site

E - Customer Service Representative (CSR)

P - CSR Tables Maintenance

(Leave Column 15 blank)

V - CSR View

CSR group or "All" for all groups within CSR site

T - Time and Attendance (T&A)

T - T&A Site Clerk

T&A group or "all" for all groups within T&A site

M - CDR MER Clerk (non-SF50)

CSR group or "All" for all groups within CSR site

B - Combined Duties Representative

P - CDR Tables Maintenance

(Leave Column 15 blank)

(CDR (CSR and T&A))

T - CDR T&A Site Clerk

T&A group or "All" for all groups within CSR site

V - CDR View

CSR group or "All" for all groups within CSR site

M - ESCR MER Clerk (non-SF50)

(Leave Column 15 blank)

I - Enhanced CSR (ECSR (CSR and T&A))

P - ESCR Tables Maintenance

(Leave Column 15 blank)

T - ESCR T&A Site Clerk

(Leave Column 15 blank)

V - ESCR View

(Leave Column 15 blank)

C - T&A Certification

C - T&A Site Certifier

Activity code or activity and organization codes

M - HRO MER Clerk (SF50)

CSR group or "All" for all groups within CSR site

P - Human Resources Office (HRO)

L - HRO Leave Bank

Agency code/major claimant code

V - HRO View

CSR group or "All" for all groups within CSR site

N - PRO View

D - Remote Disbursing Office (RDO)

D - RDO Report Printing

RDO site

V - Accounting

J - Accounting Technician

(Leave Column 15 blank)

ACTION CODE

: A - Add C - Change D - Delete

(Enter in Column 13)

13. ACTION CODE

14. DATABASE 15. AUTH TYPE 16. AUTH NO.

13. ACTION CODE

14. DATABASE

15. AUTH TYPE

16. AUTH NO.

USER AGREEMENT

I accept the responsibility for the information and DoD system to which I am granted access and will not exceed my authorized level of system access.

I understand that my access may be revoked or terminated for non-compliance with DoD security policies. I accept responsibilities to safeguard the

information contained in these systems from unauthorized or inadvertent modification, disclosure, destruction, and use. I understand that my use of the

system may be monitored as part of managing the system, protecting against unauthorized access and verifying security problems. I will ensure system

media and output are properly marked, controlled, stored, transported and destroyed based on sensitivity and need-to-know. I will report all DCPS IA-related

suspicious threats and vulnerabilities to the appropriate organization. I have completed a U.S. Government background investigation equal with the level of

access granted. I will use strong passwords, protect workstation, and not leave my CAC card or other authentication device unattended. I will keep my

security training current. I agree to notify the appropriate organization that issued my account(s) when access is no longer required.

17. USER'S SIGNATURE

18. DATE

(YYYY-MM-DD)

19. SUPERVISOR APPROVAL (Completed by user's supervisor or government sponsor)

a. CERTIFICATION OF NEED-TO-KNOW

I certify that this user requires access as requested in block 13 of the user's DD Form 2875.

c. SIGNATURE

b. SUPERVISOR/GOVERNMENT SPONSOR'S FULL NAME

d. DATE (YYYY-MM-DD)

IMPORTANT: Submit this form with the user's DD Form 2875, "System Authorization Access Request (SAAR)".