ADJUDICATION SYSTEM (JPAS) RECORD OF ELIGIBILITY FOR ...

CORPORATE LETTERHEAD

VERIFICATION OF DEFENSE SECURITY SERVICE/JOINT PERSONNEL ADJUDICATION SYSTEM (JPAS) RECORD OF ELIGIBILITY FOR ACCESS TO NATIONAL SECURITY INFORMATION

DATE:

The national security information (NSI) clearance for the following individual is hereby verified as recorded in the Department of Defense Joint Personnel Adjudication System (JPAS): Full Name: SSN: Place of Birth: Date of Birth: Type of Background Investigation: Completion Date of Background Investigation: NSI Clearance Level: Are incidents pending? Explain if yes. DEA Contract/Task Order/Purchase Order/Agreement Number: Candidate's Labor Category: Please contact me at (telephone number) if you have any questions or need additional information. Sincerely, (Signature) Typed Name of Facility Security Officer Cage Code:

(ISR 8/31/10)

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