Fort Lee Form 190-3 - Request For Unescorted Installation Access To Fort Lee Page 2
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2FORT LEE INSTALLATION ACCESS CARD/PASS
ACKNOWLEDGEMENT STATEMENT
1. I understand that I must give the Fort Lee Visitor Control Centers consent to an initial criminal history and
periodic background screenings prior to and after the issuance of an installation access card/pass by completing
Fort Lee Form 118. Failure to do so will result in the termination of the application process. I further understand that
these background screenings will determine my eligibility for access and continued access during the term of my
visit.
a. I understand that my access may be revoked at anytime without reason or notice.
b. I understand that I must properly care for my cards/pass to prevent damage, or unnecessary wear.
c. I understand that it is prohibited to allow someone else to use my card/pass.
d. I understand that my card/pass must be turned in to the Installation Access Office once it has expired
or further use is not required.
e. I understand that I must immediately report any lost, damaged or stolen card/pass to my sponsor and
the military police.
f. I understand that my card/pass must be controlled at all times. If you have and or know where your
card/pass is,then it is considered secured! If your card/pass is lost or unrecoverable, please notify your sponsor
immediately.
8. I have read and understand the instructions listed above.
APPLICANT'S PRINTED NAME
APPLICANT'S SIGNATURE
FORT LEE FORM 190-3, JAN 2015
PAGE 2 OF 2
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