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SYSTEM AUTHORIZATION ACCESS REQUEST (SAAR)

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Page 1 of 3PREVIOUS EDITION IS form 2875, AUG 2009SYSTEM AUTHORIZATION ACCESS REQUEST (SAAR)PRIVACY ACT STATEMENT AUTHORITY: Executive Order 10450, 9397; and Public Law 99-474, the Computer Fraud and Abuse Act PRINCIPAL PURPOSE: To record names, signatures, and other identifiers for the purpose of validating the trustworthiness of individuals requesting ACCESS to Department of Defense (DoD) systems and information. NOTE: Records may be maintained in both electronic and/or paper form ROUTINE USES: None. DISCLOSURE: Disclosure of this information is voluntary; however, failure to provide the requested information may impede, delay or prevent further processing of this OF REQUESTINITIALMODIFICATIONDEACTIVATEUSER IDDATE (YYYYMMDD) SYSTEM NAME (Platform or Applications)LOCATION (Physical Location of SYSTEM )PART I (To be completed by Requester)1.

DD FORM 2875, AUG 2009. SYSTEM AUTHORIZATION ACCESS REQUEST (SAAR) PRIVACY ACT STATEMENT AUTHORITY: Executive Order 10450, 9397; and Public Law 99-474, the Computer Fraud and Abuse Act . PRINCIPAL PURPOSE: To record names, signatures, and other identifiers for the purpose of validating the trustworthiness of individuals requesting

  Form, Form 8752, 8752

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(11) User's Signature. User must sign the DD Form 2875 with the understanding that they are responsible and accountable for their password and access to the system(s). (12) Date. The date that the user signs the form. B. PART II: The information below requires the endorsement from the user's Supervisor or the Government Sponsor. (13).

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(11) User's Signature. User must sign the DD Form 2875 with the understanding that they are responsible and accountable for their password and access to the system(s). (12) Date. The date that the user signs the form. B. PART II: The information below requires the endorsement from the user's Supervisor or the Government Sponsor. (13).

  Form, Form 8752, 8752

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