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System Authorization Access Request – Navy (SAAR-N)

Use this document as reference to help with filling out the form. Click pdf icon below to open the SAAR-N form.

System Authorization Access Request Form

NOTE: Some items within the form will be filled out by the ACTR for your convenience. TYPE OR REQUEST Ensure the appropriate box is check marked. If this is a new NMCI account,

then mark the INITIAL box.

If this is an existing NMCI account, then mark the MODIFICATION and USER ID box. Fill out the USER ID that is associated to modifying the account.

If deactivating the NMCI account, then mark the DEACTIVATE box.

Ensure to enter the date. The ACTR has already filled in the SYSTEM NAME and LOCATION.

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PART I (TO BE COMPLETED BY REQUESTER) Detailed instructions can also be found on page 4 of the SAAR-N Form.

The following must be filled out:

1. Name 3. Office Symbol/Department 4. Phone 5. Official E-Mail Address – For INITIAL Accounts for Contractors, use Contractor’s company email address. 6. Job Title and Grade/Rank – Contractors must enter their specific Job Title, not CTR or CONT. 9. Designation of Person 10. Information Assurance (IA) Awareness Training Requirements IMPORTANT: CHECK MARK the box if you have completed the Annual IA Awareness Training and provide the COMPLETED DATE.

The ACTR has filled the following: 2. Organization 7. Official Mailing Address 8. Citizenship

IMPORTANT Check Mark the IA Awareness Training

IMPORTANT Provide the IA AWARENESS COMPLETION DATE

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PART II - ENDORSEMENT OF ACCESS BY INFORMATION OWNER, USER SUPERVISOR OR GOVERNMENT SPONSOR

The information below requires the endorsement from the user's Supervisor or the Government Sponsor. The following must be filled out: 11. Justification Access – Date of birth is required in the following format: YYYY MM DD

13. User Requires Access To IMPORTANT: CHECK MARK either

UNCLASSIFIED, CLASSIFIED, or CHECK MARK BOTH boxes if you require both an UNCLASSFIED and CLASSIFIED access. If CLASSIFIED is check marked specify the category: SIPRNET (see example below)

14. Verification of Need to Know IMPORTANT: This MUST be check

marked! Place an X in the box. (see example below)

14a. Access Expiration Date IMPORTANT: CONTRACTORS need to

have all 3 components: COMPANY NAME, CONTRACT NUMBER, and EXP DATE (see example below)

15. Supervisor’s Organization/Department 15a. Supervisor’s E-mail Address 15b. Phone Number 16. Supervisor’s Name 16a. Supervisor’s Signature 16b. Date

The ACTR has filled the following: 12. Type of access Required

Company Name

Contract Number

Expiration Date

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PART II - ENDORSEMENT OF ACCESS BY INFORMATION OWNER, USER

SUPERVISOR OR GOVERNMENT SPONSOR (CONTINUATION)

The following must be filled out: 23. Name 25. Date – DATE FIRST BEFORE SIGNING, once the document is signed, it cannot be modified. 24. User Signature IMPORTANT: Click the signature

field to sign, and Adobe Acrobat will prompt to select a certificate.

Ensure that the U.S. Government (DoD in this case) is selected before the “Sign” button is selected. (See examples below)

After clicking Sign, the left portion of the digital signature will be in the format LAST.FIRST.MI.1234567890, as seen in the example below.

The 10-digit EDIPI number (aka DoD ID Number) is also displayed three additional times on the right portion of the digital signature block.

The phrase “U.S. Government” will be in the signature block as well.

NOTE: PART III – Security Manager Validates the Background Investigation or Clearance Information is the responsibility of SPAWAR Security. ACTR will have 26c IT Level Designation preselected.

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