KEY MANAGEMENT - University of Central Florida



|IST OF KEY | |FACILITY CAGE CODE (FSC#) |

|MANAGEMENT PERSONNEL |INITIAL REPORT (Date) | |

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| |CHANGE REPORT (Date) | |

|FACILITY NAME, ADDRESS, AND ZIP CODE (As it appears on the DD Form 441 or DD Form 441-1) |

| |DATE, | |SECURITY |

|FULL NAME & |PLACE OF BIRTH & CITIZENSHIP |SOCIAL SECURITY NUMBER |CLEARANCE LEVEL |

|POSITION / TITLE | | |(If EXCLUDED, provide date) |

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|I CERTIFY THAT THE INFORMATION INCLUDED HEREON IS TRUE, COMPLETE, AND CORRECT TO THE BEST OF| | |

|MY KNOWLEDGE. |_________________________________________ |PAGE ___ of |

|{REQUIRES SIGNATURE OF ONE LISTED OFFICIAL} |(Signature / Position) |___ PAGES |

| |REVISED 7/95 XR |

NISPOM REQUIREMENTS RELATING TO KEY MANAGEMENT OFFICIALS

2-104. Personnel Clearances Required in Connection with the FCL.

The senior management official and the FSO must always be cleared to the level of the FCL. Other officials, as determined by the CSA, must be granted a PCL or be excluded from classified access pursuant to paragraph 2-106.

2-106. Exclusion Procedures.

When, pursuant to paragraph 2-104, formal exclusion action is required, the organization's board of directors or similar executive body shall affirm the following, as appropriate.

a. Such officers, directors, partners, regents, or trustees (designated by name) shall not require, shall not have, and can be effectively excluded from access to all classified information disclosed to the organization. They also do not occupy positions that would enable them to adversely affect the organization's policies or practices in the performance of classified contracts. This action shall be made a matter of record by the organization's executive body. A copy of the resolution shall be furnished to the CSA.

b. Such officers or partners (designated by name) shall not require, shall not have, and can be effectively denied access to higher-level classified information (specify which higher level(s)) and do not occupy positions that would enable them to adversely affect the organization's policies or practices in the performance of higher-level classified contracts (specify higher level(s)). This action shall be made a matter of record by the organization's executive body. A copy of the resolution shall be furnished to the CSA.

1-302 Reports to be Submitted to the CSA.

h. Change Conditions Affecting the Facility Clearance.

(3) Any change to the information previously submitted for key management personnel including, as appropriate, the names of the individuals they are replacing. In addition, a statement shall be made indicating: (a) Whether the new key management personnel are cleared, and if so, to what level and when, their dates and places of birth, social security numbers, and their citizenship; (b) Whether they have been excluded from access; or (c) Whether they have been temporarily excluded from access pending the granting of their clearance. A new complete listing of key management personnel need only be submitted at the discretion of the contractor and/or when requested in writing by the CSA.

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