NFO-205 Rev. 0
(08/2015)
Older Versions Obsolete
INFORMATION REQUIRED FROM UNCLEARED U.S. CITIZENS FOR
TOURS OF NATIONAL NUCLEAR SECURITY ADMINISTRATION
NEVADA FIELD OFFICE (NNSA/NFO)FACILITIES
US/DOE
NNSA/NFO
Name of Group Date of Visit
Name of Contact Person Contact’s Telephone (Include Area Code)
LAST Name First Middle Initial (MI)
(If no MI, write
NMI)
Date of Birth Place of Birth (City and State) Citizenship
E-Mail Address:
Badge #: Level of Clearance:
Purpose of Visit:
Company Name: Job Title:
Business Street Address Residence Street Address (No P.O. Boxes)
Business City, State, and ZIP Code Residence City, State, and ZIP Code
Business Telephone (Include Area Code) Residence Telephone (Include Area Code)
Badging Instructions (to be completed by the NNSA/NFO Visit Control Office):
PRIVACY ACT
STATEMENT
The information requested on this form is protected by the Privacy Act of 1974. The purpose for requesting this information is
to
enable proper processing of your background information for access to the U.S. Department of Energy, NNSA/NFO
facilities.
Failure to provide the requested information may preclude processing your badging
request.
