OPNAV 5239/14: System Authorization Access Request Navy (SAAR-N)

Under TYPE OF REQUEST, mark INITIAL, MODIFICATION or DEACTIVATE USER ID.

Enter the DATE (DDMMMYYYY), the SYSTEM NAME (Platform or Application) and the LOCATION (Physical Location of System).

The requester completes Part I; the user provides this information when establishing or modifying their USER IDENTIFICATION (ID).

In Box 2, ORGANIZATION, enter the user's current organization (i.e., USS xx, DoD, and government agency or commercial firm).

In Box 3, OFFICE SYMBOL/DEPARTMENT, enter the office symbol within the current organization (i.e., SDI).

In Box 4, PHONE (DSN and Commercial), enter the Defense Switching Network (DSN) and commercial phone number of the user in DSN and COM.

In Box 5, OFFICIAL E-MAIL ADDRESS, enter the user's official e-mail address.

In Box 6, JOB TITLE AND GRADE/RANK, enter the civilian job title (i.e., Systems Analyst YA-02, military rank (CAPT, United States Navy) or "CONT" if user is a contractor.

In Box 7, OFFICIAL MAILING ADDRESS, enter the user's official mailing address.

In Box 8, CITIZENSHIP, identify United States, Foreign National (FN), Local National (LN), or Other, appropriate citizenship in accordance with (IAW) SECNAV M-5510.30.

In Box 9, DESIGNATION OF PERSON, mark MILITARY, CIVILIAN or CONTRACTOR.

In Box 10, the user must indicate if he/she has completed the Annual Information Awareness Training and the date of completion.

Part II requires the endorsement from the user's Supervisor or the Government Sponsor; if an individual is a contractor, provide company name, contract number, and date of contract expiration in Block 14a.

In Box 11, JUSTIFICATION FOR ACCESS, a brief statement is required to justify establishment of an initial USER ID; provide appropriate information if the USER ID or access to the current USER ID is modified.

In Box 12, TYPE OF ACCESS REQUIRED, place an "X" in the appropriate box: Authorized (individual with normal access) or Privileged (those with privilege to amend or change system configuration, parameters or settings).

If Block 12 is checked "Privileged", user must sign a Privileged Access Agreement Form; enter the date when the Privilege Access Agreement (PAA) form was signed in DATE SIGNED (DDMMMYYYY). Users can obtain a PAA form from the Information Assurance Manager (IAM) or Appointee.

In Box 13, USER REQUIRES ACCESS TO, place an "X" in the appropriate box: UNCLASSIFIED, CLASSIFIED (Specify Category) or OTHER, and specify category.

Box 14, VERIFICATION OF NEED TO KNOW, is to verify that the user requires access as requested. The form prints "I certify that this user requires access as requested."

In Box 14a, ACCESS EXPIRATION DATE, the user must specify expiration date if less than 1 year; contractors must specify Company Name, Contract Number, Expiration Date.

In Box 15, SUPERVISOR'S ORGANIZATION/DEPARTMENT, enter the supervisor's organization and department; in Box 15a, the supervisor's e-mail address; in Box 15b, the supervisor's telephone number.

In Box 16, SUPERVISOR'S NAME (Print Name), the supervisor or representative prints his/her name to indicate that the above information has been verified and that access is required; the supervisor's signature is required by the endorser or his/her representative in Box 16a, and Box 16b is the date supervisor signs the form.

In Box 17, SIGNATURE OF INFORMATION OWNER/OPR, the functional appointee responsible for approving access to the system being requested signs; Box 17a is the functional appointee telephone number and Box 17b is the date the functional appointee signs the OPNAV 5239/14.

In Box 18, SIGNATURE OF IAM OR APPOINTEE, the IAM or Appointee of the office responsible for approving access to the system being requested signs; Box 19 is the IAM's organization and department. Box 20 is the IAM's telephone number. Box 21 is the date the IAM signs the OPNAV 5239/14 form.

In Box 24, USER SIGNATURE, the user must sign the OPNAV 5239/14 with the understanding that they are responsible and accountable for their password and access to the system(s).

Box 23 is the last name, first name, and middle initial of the user; Box 25 is the date signed.

Part III is the certification of background investigation or clearance; Box 26, TYPE OF INVESTIGATION, is the user's last type of background investigation (i.e., National Agency Check (NAC), National Agency Check with Inquiries (NACI), or Single Scope Background Investigation (SSBI)).

Box 26a, DATE OF INVESTIGATION, is the date of last investigation; Box 26b, CLEARANCE LEVEL, is the user's current security clearance level (Secret or Top Secret).

In Box 26c, IT LEVEL DESIGNATION, identify the user's IT designation level: if Block 12 is designated as "Authorized" then IT Level Designation is "Level III"; if Block 12 is designated as "Privileged" then IT Level Designation is "Level I or II" based on SECNAV M-5510.30 dtd June 2006.

In Box 27, VERIFIED BY, the Security Manager or representative prints his/her name to indicate that the above clearance and investigation information has been verified. Box 28 is the telephone number of the Security Manager or his/her representative. Box 29 is the Security Manager's signature. Box 30 is the date that the form was signed by the Security Manager or his/her representative.

Part IV is site specific and can be customized by either the functional activity or the customer with approval from OPNAV; this information will specifically identify the access required by the user. For Boxes 31 to 33b, fill in appropriate information.