Oak Ridge National Laboratory (ORNL) Technical Contact Statement

In making this request for access to the ORNL managed unclassified ADP resources(s) for the individual named below, I understand and assume the following responsibilities:
  • I will verify the applicant’s need-for-access to the requested systems(s);
  • I will accept and deliver the applicant’s temporary password to the applicant;
  • I will re-verify the applicant’s need-for-access as requested by UCAMS management personnel;
  • I will notify CAA when the applicant’s need-for-access to the requested system(s) is no longer required; and,
  • I understand these responsibilities are subject to audit.
Tech. Cont. Name: Badge Number:
Tech. Cont. Signature:
Date:
Phone Number:    
Note: The Technical Contact should be the Division host of the non-employee as identified in the NonEmployee Processing System (NEP). If the Division Host is not an ORNL employee, the host's supervisor should be the technical contact.
SubContractor Information
Sub. Userid: Sub. Name:
Sub. Badge: Sub. Security Clearance Level:
Sub. Plant Address: Sub. Phone:
Company Name: Assignment End Date (NEP):

Centrally Managed Computer or
Database accounts (UCAMS) requested



     Non-centrally Managed Computer or
Database accounts (not UCAMS) requested:



Please use your browser's "Print" function and proceed with the following instructions.

The information and signature on this page should be completed by the specified Technical Contact. The form should then be faxed or mailed to Computer Access and Authorizations (for internal/plant mail: CAA, 151LAF, MS-SAIC; for external mail: CAA, SAIC, 301 Laboratory Road, Oak Ridge, TN 37830 or CAA, SAIC, P.O. Box 2501, Oak Ridge, TN, 37831; FAX: 865-425-5243). A copy of the form should also be printed and retained by the signer for documentation purposes.

Note: The subcontractor for whom the userid/accounts are being requested must also read and complete a "User Acknowledgement Form" before any accesses will be granted.

CAA Forms  |  Helpline  |  ORNL Home  |  Search
Notice to Users
Developed and maintained by SAIC Technology Services Company