DEfense Supply eXpert System (DESX) Registration Form for Foreign National Employees
Please Mail or FAX this form to:
Mail : FAX:
DLIS-TS (DESX Access) DSN: 661-5925
Defense Logistics Information Service Commercial: 269-961-5925
74 Washington Ave N, Ste 7
Battle Creek, MI 49017-3084
PLEASE TYPE OR PRINT CLEARLY.
Instructions for completing this form
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. Military/Service Sponsor Information
Please provide your address and Point of Contact (POC) for this request:
Mailing Address.
POC Name___________________________________________________________________
Mailing Address_______________________________________________________________
_________________________________________________________________
_________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Telephone Number_____________________________________________________________
Facsimile (FAX) Number________________________________________________________
EMAIL Address_______________________________________________________________
Level of Access and Sponsor approval
_______ Read Only Access – The foreign national employee 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 – The foreign national employee is authorized to submit new requisitions and modify requisitions using DESX.
_______ DESX Web Program Administrator – The foreign national employee requires approval for access to DESX’s web program management tools so that I may examine DESX statistics
Signature of Approving Official:___________________________
Title:_____________________________________________________
Commercial Phone:_____________________DSN:_________________
Block 2 DESX User Information
This form requests that you provide your social security number or employee id 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 DLA:
I understand the need to protect my password. I will NOT share my password and/or account.
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 DLA 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 DLA 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 DLA 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 password. I will NOT share my password/and/or user ID. If I no longer need access to DESX, it is my responsibility to notify DLIS.
Printed Name____________________________________________________
Country Where Employed___________________________________________________
Grade, Rank, Official Title_____________________________________________________
Date of Birth__________________________________________________________________
Type & Level of Government Check_____________________________________________
Citizenship__________________________________________________________________
Employee ID Number ________________________________________________
Telephone Number______________________________________________________
Email Address___________________________________________________________
**** Personal Identification Information (This may be your favorite color, sports team, hobby or phrase you will remember). _______________________________****
Block 3. Privacy/Security Notices
This DLA Automated Information System (AIS) accessed via telephone, website and email is provided as a public service by the agency.
2. Information presented on this DLA AIS is considered public information and may be distributed or copied. 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.
Blocks 2 and 3must be read and signed acknowledging acceptance of the above statements.
USER SIGNATURE_____________________________ DATE _____________________
Block 4 Security/Background Statement
We have performed a security and background check/or police check on the individual named above. We recommend that this person should be allowed to access DESX.
Typed Name of Security Office Official_____________________________________________
Signature of Security Office Official________________________________________________
Official Title/Grade____________________________________________________________
Date____________________________
Telephone Number___________________________________________________________
EMAIL__________________________________________________________________
Facsimile (FAX) Number_________________________________________________