Registration Form for LOGRUN for
U.S. Government Sponsored Contractors
Please TYPE or PRINT CLEARLY then mail or fax this form to:
Mail: FAX:
DLIS-VSM (LOGRUN Access) DSN: 661-5925
Defense Logistics Information Service Commercial: 269-961-5925
74 Washington Ave N, Ste 7
Battle Creek MI 49017-3084
Instructions for completing this form
LOGRUN General Information
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 Sponsor Branch of Service: ______________________________
(Example: Army, Navy, Air Force, DLA, GSA, Marine Corps, FAA, VA, NASA).
Major Command:
_____________________________________________________
(Example: Army Materiel Command, Air Force Materiel Command, Naval Supply
Command, etc.)
Government Contract Office Representative (COR) (By signing this block, you agree that the contractor named in Block 3 needs access to LOGRUN (FLIS) 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:______________
FAX:_______________________________________________________
Email:______________________________________________________
Contract Number:____________________________________________
Contract End Date___________________________________________
TYPE OF ACCESS REQUIRED:
______ LOLA Inquiry
______ Register for GUI LOLA - LOLA 97
Do you need GUI LOLA - LOLA97 software? ______yes ______no
Windows XP version _____ all other window versions ______
LEVEL OF ACCESS REQUIRED:
Limited Rights Data? _______ Yes ______ No
Note: Limited Rights Data requires written justification in Sponsor’s cover letter and completion of Non-Disclosure forms. These forms will be mailed to the Sponsor when we receive this request.
Block 3. LOGRUN 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 LOGRUN, 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 LOGRUN, it is my responsibility to notify DLIS.
USER SIGNATURE_____________________________DATE:_____________
Printed Name:____________________________________________________
Social Security Number (last six digits):________________________________
Email:__________________________________________________________
Commercial Phone:_______________________DSN:____________________
Personal Identification Information: (This may be your favorite color, sports team, hobby or phrase.) _______________________________________________________________
Block 4. Security Verification
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:_______________
By (Agency):__________________________________________________
Signature of Security Representative:_______________________________
Printed Name of Security Representative:____________________________
Title:____________________________________ Date:________________
Commercial Phone:_____________________ DSN:___________________