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ASG-KU EXCEPTION TO POLICY FORM |

AUTHORITY: AR 190-16, AR 600-8-14, AR 600-8-104, USCENTCOM OPORD 10-05 Antiterrorism, AFR 207-4, OPNAVINST 5530.15a, MCO 5500.13a, DoD 1000.13p, ASG-KU Installation Access Policy.PRINCIPAL PURPOSE: To evaluate an applicant requesting an exception to specific requirements of ASG-KU policies related to Installation Access.ROUTINE USES: To establish a record for approval/disapproval of exception and to verify an applicant with an approved exception. Approved Prohibited Item Exceptions must be carried at all times while on any ASG-KU Installation and presented to military, law enforcement, or security personnel upon request.DISCLOSURE REQUIREMENT – THIS INFORMATION IS VOLUNTARY: Failure to provide the documentation and information requested, including a Foreign Identification number, may result in the disapproval of this application. Exceptions may require additional screening, interview and background checks. Any derogatory information returned from the applicant’s background investigation or failure to comply with screening/interview requirements may result in denial of exception and barment proceedings being initiated. Personal information such as SSN, Passport or Kuwait Civil ID number provide an individual with a unique identification and will be handled as OFFICIAL USE ONLY in accordance with Federal Statutes. |

SECTION I – POLICY EXCEPTION REQUEST |

Exception Type: Access Exception Passport POV Prohibited Items Exception Other _________________________ |

Policy Reference (please provide policy, page number, section, paragraph, and subparagraph):      |

Description of Exception Requested:      |

Applicant Name:      | Title and/or Position:      | Location:      |

Kuwait Civil ID Number:     Passport Number:      | Date of Birth:      | Nationality:      |

Justification (please provide information to determine eligibility):      |

SECTION II – REQUESTING AUTHORITY...