ENVIRONMENTAL REPORTING LOGISTICS SYSTEM (ERLS)
Instruction for completing this form Please return this
form to DLIS-VSM (ERLS Access),
74 Washington Ave N STE 7,
Battle Creek MI 49017-3084. FAX: Commercial (269) 961-5925 or DSN 661-5925. These instructions are for completing the Environmental
Reporting Logistics System (ERLS) registration form. Contractor completes
Blocks 1, 3 and 4. U. S. Government sponsor completes Block 2. Command
Security or Personnel completes Block 5.
PLEASE TYPE OR PRINT CLEARLY. 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. Agency
Information -
Please provide information on the branch of the Government where you are
presently working. U.S. Government Branch of Service or
Agency:____________________ Major
Command:_____________________________________________ Activity
Name:_____________________________________________ Installation
Name:___________________________________________ Block 2. Government
Contract Office Representative (COR) 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 3. Company
Name and Mailing Address, Contractor Point of Contact Information:
POC
Name:______________________________________________ Company
Name:__________________________________________ Street Address/PO
Box:____________________________________ City/State/ZIP
Code:_______________________________________ City/Country (If APO
or FPO Address):________________________ Commercial
Phone:_________________________DSN:___________
FAX:____________________________________________________
Email:____________________________________________________ Contract Number:__________________________________________ Length of Contract: End Date__________________________________________________ Block 4. ERLS User
Information. As a user of ERLS, 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 ERLS, it is my responsibility to notify DLIS. USER SIGNATURE___________________________DATE:__________ Printed
Name:__________________________________________________ Social Security Number
(last six (6) digits only):_________________________ DLA Standard
LOGON:__________________________________________
Email:________________________________________________________ Commercial
Phone:________________________DSN:__________________ Personal
Identification Information – (This may be your favorite color, sports
team, hobby or phrase.)
(1)_________________________________________________________ |
|
Customer Service: 1-877-352-2255 or DSN 661-7766 Email: DLIS-Support@dlis.dla.mil Privacy/Security | Accessibility | Contact Webmaster This Site Reviewed Quarterly Last Updated: Wednesday, July 21, 2004 |