ACTIVITY SECURITY CHECKLIST DIVISION/BRANCH/OFFICE ROOM ...
ACTIVITY SECURITY CHECKLIST
DIVISION/BRANCH/OFFICE
ROOM NUMBER
MONTH AND YEAR
Irregularities discovered will be promptly reported to the designated Security Office for corrective action.
TO (if required)
FROM (if required)
Statement
I have conducted a security inspection of this work area and checked all the items listed below.
THROUGH (if required)
*ITEM
1.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
2.
3.
4.
5.
6.
7.
8.
INITIAL FOR DAILY REPORT
TIME
* Fill in each ITEM as needed in order to meet your organization's requirements; e.g. "1. Security alarm(s) and related equipment have been activated (where appropriate)."
701-101 NSN 7540-01-213-7899
STANDARD FORM 701 (11-2010) Prescribed by NARA/ISOO 32 CFR PART 2001 EO 13526
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