DEfense Supply eXpert System (DESX)

Registration Form for U.S. Government Sponsored Contractors

Government Sponsor can FAX or mail this form to us at:

Mail:                                                               FAX:
DLIS-VSM (DESX Access)                               DSN 661-5925
Defense Logistics Information Service          Commercial (269) 961-5925
74 Washington Ave N STE 7
Battle Creek MI 49017-3084

This is a Department of Defense (DoD) computer system. DOD computer systems are provided for the processing of official U.S. Government information only. All data contained on DoD computer systems is owned by the Department of Defense, may be monitored, intercepted, recorded, read, copied, or captured in any manner and disclosed in any manner, by authorized personnel. There is no right to privacy in this system. System personnel may give to law enforcement officials any potential evidence of crime found on DoD computer systems. Use of this system by any user, authorized or unauthorized, constitutes consent to this monitoring, interception, recording, reading, copying, or capturing and disclosure.

Block 1. Sponsor Information – This block must be completed and signed by the U.S. Government Contracting Officer Representative.

U.S. Government Branch of Service or Agency: _____________________________________
(Such as Army, Navy, Air Force, DLA, GSA, NASA, etc.)

Major Command: __________________________________________________
(Such as Army Materiel Command, Air Force Materiel Command, Naval Supply Command, etc.)

Government Contract Officer Representative (COR). By signing this block, you agree that the contractor named in Block 3 needs access to DESX in order to perform their contractual obligations at your agency.

COR Signature:___________________________________________________

COR Name (print):________________________________________________

Office Symbol/Code/Mail Stop:_____________________________________

Organization:___________________________________________________________

Street/PO Box: _________________________________________________________

City/State/ZIP Code:_____________________________________________________

City/Country (If APO or FPO address):_______________________________________

Commercial Phone: _____________________ DSN:____________________

Email Address: ______________________________________________________

FAX: ______________________________

Block 2. Contractor Information

POC Name: ________________________________________________________

Company Name: _____________________________________________________

Street Address/PO Box: _______________________________________________

City/State/ZIP Code: __________________________________________________

City/Country: ________________________________________________________

Commercial Phone: ______________________ DSN Phone:__________________

Commercial Fax: ________________________ DSN FAX:____________________

Email:_______________________________________________________

Contract Number: ______________________________________________

Contract End Date: ____________________________________________

Block 3. DESX User Information

This form requests that you provide your Social Security Number. The U.S. Government is authorized to ask for this information under Executive Orders 9397, 10450 and 10577 sections 3301 and 3302 of title 5, U.S. Code and parts 4, 731 and 736 of Title 5, Code of Federal Regulations. Your Social Security Number is needed to keep records accurate, because other people may have the same name. The primary use of the information on this form is for review by Government Officials to determine and verify that you have the appropriate security clearance to obtain access to the requested data. Disclosure is voluntary. However, failure to provide the requested information may result in denial of access.

As a user of DESX, I acknowledge my responsibility to conform to the following requirements and conditions as established by Defense Logistics Agency:.

I understand the need to protect my account. I will NOT share my password, PIN, or User ID.

I understand that I am responsible for all actions taken under my account. I will NOT attempt to ‘hack" the network or any connected information system or network, or attempt to gain access to data for which I am not specifically authorized.

I acknowledge my responsibility to comply with all copyright laws both federal and state where applicable.

I understand my use of Defense Logistics Agency Information systems is subject to monitoring to ensure proper functioning, to protect against improper or unauthorized use or access, and to verify the presence or performance of applicable security features or procedures. By using the information system I consent to such monitoring.

I acknowledge my responsibility to conform to the requirements stated above when using Defense Logistics Agency information systems or networks. I also acknowledge that failure to comply with these requirements and conditions may constitute a security violation resulting in denial of access to Defense Logistics Agency information systems, networks or facilities and that such violations will be reported to appropriate authorities for further action as deemed appropriate.

I understand the need to protect my DESX account If I no longer need access to DESX, it is my responsibility to notify DLIS.

Printed Name: __________________________________________________________

Social Security Number:___________________________

DLA Standard LOGON or User ID: __________________________________

Email: __________________________________________________________

Commercial Phone: ________________________DSN Phone:__________________

Personal Identification Information (This may be your favorite color, sports team, hobby or phrase you will remember). ____________________________________________________________

Block 4. Level of Access check the role(s) applicable to your user of DESX

_______ Read Only Access – I will use DESX to review the availability of assets, usually preparatory to placing an order, and to check the status of requisitions.

_______ Read and Write Access – I am authorized to submit new requisitions and modify requisitions using DESX.

_______ DESX Web Program Administrator – I require approval for access to DESX’s web program management tools so that I may examine DESX statistics.

Block 5. Privacy/Security Notices

1. This DLA Automated Information System (AIS) accessed via telephone, website and email is provided as a service by the agency.

2. Information presented on this DLA AIS is considered unclassified information.. Use of appropriate byline/photo/image credits is requested.

3. For site management, information is collected for statistical purposes. This government computer system uses software programs to create summary statistics, which are used for such purposes as assessing what information is of most and least interest, determining technical design specifications, and identifying system performance or problem areas.

4. For site security purposes and to ensure that this service remains available to all users, this government computer system employs software programs to monitor network traffic to identify unauthorized attempts to upload or change information, or otherwise cause damage.

5. Unauthorized attempts to upload information or change information on this service are strictly prohibited and may be punishable under the Computer Fraud and Abuse Act of 1986 and the National Information Infrastructure Protection Act.

6. Information located on this site is not official documents. For official documents please contact the Webmaster@desx.com.

Blocks 3 and 5 must be read and signed acknowledging acceptance of above statements.

USERS SIGNATURE_________________________________ Date _____________________

Block 6. Security Verification

DoD sponsored contractors: have your Contract Officer Representative/Security office sign where indicated below; your form will be returned without further action if this section is not completed.

Security Officer. Access to this system requires the user to have a National Agency Check (NAC) or equivalent type of investigation. If this level of investigation has not been completed for this person, contact the Defense Security Service at http://www.dss.mil for assistance.

Verification of Security for requester named in Block 3:

Employee Name: _____________________________________________

Type of Investigation: _________________________ Completed on: _________________

ADP Level ______________________

By (Agency):_______________________________________________________________

Signature of Security Representative: ___________________________________________

Typed Name of Security Printed Name:__________________________________________

Title: _____________________________________ Date:___________________________

Commercial Phone:_______________________ DSN:__________________

Thank you for completing this DESX Registration Form.