Fillable Fort Hunter Liggett (FHL) 202122 Hunting/Fishing Access Request

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Fort Hunter Liggett (FHL) 202122 Hunting/Fishing Access Request

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Not applicable
(Archery hunting or Fishing ONLY)
Section 1. Personal Information (Failure to Provide ALL Information May result in Denied Access)
2. Date of Birth (MM/DD/YYYY):
1. Name (As it appears on ID) Last Name: First Name: FULL Middle Name:
Authority: Public Law110-181, The 2008 National Defense Authorization Act, Section109.
Principal Purpose:
Provide necessary information to determine if applicant meets the installation access requirements in accodrdance with the U.S. Army Garrison, Fort Hunter Liggett Command Policy # 10-
9, Installation Access Procedures for Visitors. Use of Date of Birth, Driver License Number and Social Security Number (SSN) are necessary for positive identification of the applicant in the Department of
Justice database.
Routine Use:
National Crime Information Center Interstate Identification Index (NCIC-III) criminal history check using the Department of Justice database.
Disclosure is Voluntary:
Disclosure of SSN and other information is voluntary. However, applicant's failure to provide requested information will result in a delay or denial of installation access.
See Page 2 for information concerning this form.
Fort Hunter Liggett (FHL)
2021–22 Hunting/Fishing Access Request Form
THIS FORM IS SUBJECT TO THE PRIVACY ACT OF 1974
Information collected in this form is
FOR OFFICIAL USE ONLY
.
State: Country:
12. Country of Citizenship (
If not U.S answer block 14):
11. Place of Birth: City:
13. Passport Number: 14. List Immigration Document (Doc #, Type of Doc and Expiration Date):
17. Email Address 18. I have read and understand all statements on the back of this form. Signature and Date:
Section 2.
Purpose of Request
(check all that apply)
16. Home Phone Number:Zip Code:State:City:15. Current Address: House Number & Street:
3. Driver's License/ID Number
State Issued From:
5. Sex:4. Social Security Number (SSN): 10. Weight:9. Height:8. Hair Color:7. Eye Color:6. Race:
Hunting W/Firearm (1 Jul 2021 - 30 Jun 2022)
Hunting Archery (1 Jul 2021 - 30 Jun 2022)
Firearms Registration:
Yes. All firearms coming aboard base are registered with base.
No.
You will need to register them. Registration can be submitted with ARF. See iSportsman for information on how to register firearms. If this is
your first year hunting you will be reminded to register your firearms. If you have previously hunted on base and still have not registered your
firearms your Access Request Form will be put on hold until your firearms registration is submitted.
FHL Form 7-2, April 2021 Page 1 of 2PREVIOUS EDITION IS OBSOLETE
Signature of Person Vetting: Date:
CLETS Message Number:
FBI Number:
Access Granted Access Denied
Time:Print Name of Person Vetting:
Section 3. Approval or Denial (To Be Completed by DES Personnel Only)
Fishing (1 Jan 2021 - 31 Dec 2021)
Guest of Hunter/Angler (Can not touch hunting/fishing equipment)
Acceptable Documents for Verification of Identity:
(You must provide a copy of one of the below listed documents with your Access Request)
State Issued Real ID Compliant Driver’s License or ID Card
US or Foreign Passport or Passport Card
Border Crossing Card (Form DSP-150)
Department of Homeland Security “Trusted Traveler” Cards
Veteran’s Health ID Card issued by the U.S. Dept. of Veterans Affairs
U.S. Permanent Resident Card (Form I-551)
Certificate of Naturalization (Form N-550 or N-570)
Transportation Worker Identification Credential (TWIC)
Addi
tional Documents: If operating a vehicle you must present a valid Driver’s License, current vehicle registration and proof of
valid insurance upon arriving at the Visitor Control Center (VCC) for your pass.
I un
derstand the information on this form is being collected in accordance with 50 U.S.C., Section 797, and DoD 5200.8, and federal
laws permitting the installation commander to limit access to the installation for security reasons. I have voluntarily completed this
form. The information I have provided on this application is true, complete, and correct to the best of my knowledge and believe,
and is provided in good faith. I understand that a knowingly and willfully making a false statement on this application can be
punished by fine or imprisonment or both (18 U.S.C. Section 1001).
The pur
pose for requesting information is to assist Access Control personnel in documenting visitor’s suitability for access to Fort
Hunter Liggett. Social Security Number and date of birth are necessary to identify the person and records. This information may be
used to determine suitability of person desiring access to Fort Hunter Liggett; as well as; for lawful purposes including law
enforcement and litigation. This information will be used to generate state and federal criminal history records checks.
This
form can be sent to the VCC for processing in any of the ways listed below:
1. Can b
e mailed to:
`
2. Can b
e Emailed to:
Directorate of Emergency Services
Attn: VCC
P.O. Box 893
Fort Hunter Liggett, CA 93928-0893
usarmy.hunterliggett.id-readiness.mbx.des-vcc@mail.mil
3. Can be dropped off at the Visitor Control Center (VCC) between the hours of 9:00AM to 3:00PM Monday – Friday, (closed
federal holidays). Dropping it off at the VCC will not speed up the vetting process. It will only ensure delivery.
Per
sons who do not pass the security vetting will be denied Hunting/Fishing privileges and access to Fort Hunter Liggett. If you are
denied you will be sent an access denial waiver package. The appeal process is governed by Army Directive 2014-05.
Any co
nduct which is detrimental to the maintenance of good order and discipline aboard Fort Hunter Liggett may result in
confiscation of the visitor pass/badge and loss of H/F privileges.
Pas
s holders will confine themselves only to those areas related to issuance of the pass. Pass holders will not enter any marked
restricted and/or controlled areas.
Vehi
cles and packages may be inspected at any time during a Random Antiterrorism Measures (RAM) while aboard the installation.
Any fi
rearm brought onto Fort Hunter Liggett for legitimate activity is required to be registered with the Directorate of Emergency
Services (DES).
Concealed weapons permits are not valid on Fort Hunter Liggett/Parks Reserve Forces Training Area.
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Fort Hunter Liggett (FHL) 202122 HuntingFishing Access Request

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Completed 22 February 2022

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