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Procedures for Federal Users Application Form

For all federal employees who are users of the PLGR's, here are some guidelines that must be performed in order for an expeditious process. Below is an example on how to fill out an Federal User Form, along with a brief description of procedures. At the end of this category is a blank form in PDF format that can be downloaded. This form have been officially approved and cannot be changed or altered in any way or form.

Remember every user is obligated to fill out this form before attaining access to the PLGRs. If this is not met, that user will refrain from any use of the PLGRs. Also all paperwork must be submitted to the GPS Center or Field Station Coordinator, no exceptions. Failure to comply will be grounds for revocations of User access and will result in removal from total access to the Federal PPS program.

2. Federal User Form

Applies to Federal employees that aren't PLGR custodians but want to be users. This basically means a user wants to temporarily borrow a PLGR from a custodian. Each user is required to comply with the following examples and instructions:

1) Section I and II is an example of a fully completed form.

a) Section I reveals Identification of Federal Custodian/User, Identification of Federal Supervision and Identification of Receiver & Storage or Part I, II and III.
b) Section II reveals Certification Statements and Approval or Part IV and V.

2)Part I, II and III:

a) Fill this form out completely leaving nothing blank.
b) Enter N/A (not applicable) in places that don't apply to you.
c) DO NOT send proof of citizenship. Active federal employees have this on file at Personnel. Self-certify your status.
d) State either birth certificate or passport under Type of Proof.
e) There can be several PLGR serial numbers on one application for each custodian.

3) Part IV and V:

a) The custodian of the PLGR must sign and date under Coordinator/Custodian.
b) The user also must sign and date under Custodian/User.
c) The Property Management Officer or your Supervisor must sign and date uner Chief Property Management Officer.

4) The GPS Center Coordinator or the GPS Field Station Coordinator must keep the originals on file and maintain a users log sheet.
5) DO NOT send to the Agency Coordinator. This is for your records only.

NOTES:

1) If a user is going to have access to several PLGRs, than that user has to fill out a separate form for each PLGR. This is because each PLGR might have a different custodian. But if the custodian has his or her name on all the PLGRs, than the user only has to fill out one form.

2) If an individual is born outside the U.S. and their parents are U.S. citizens or has been naturalized as a U.S. citizen, that individual is considered a U.S. citizen.

Blank Federal User Application (PDF file)

Please note: PDF versions of of this blank form require version 7.0 of the Adobe Acrobat Reader in order to view them. Users should download a free copy of Acrobat Reader 7.0.

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Comments, questions or suggestions? Send email to: rspengle@usgs.gov