Form AF 2583 at a glance
What it is: AF 2583 is the REQUEST FOR PERSONNEL SECURITY ACTION. The form is used to identify investigation, security clearance, unescorted entry requirements, and special access program authorizations.
Who signs: Enter 12. DATE and 13. TYPED NAME, GRADE AND TITLE OF REQUESTER, and the requester signs 14. SIGNATURE. Enter 16. DATE, 17. TYPED NAME AND GRADE OF BASE DIRECTOR, MEDICAL SERVICES and 18. SIGNATURE. Enter 20. DATE, 21. TYPED NAME AND GRADE OF SECURITY POLICE OFFICIAL and 22. SIGNATURE. Enter 24. DATE, 25. TYPED NAME, GRADE AND TITLE OF APPROVING AUTHORITY and 26. SIGNATURE. Enter 27. DATE, 28. TYPED NAME, GRADE AND TITLE OF SPECIAL ACCESS PROGRAM CERTIFYING OFFICIAL and 29. SIGNATURE.
A filled-in Form AF 2583 example: a Top Secret clearance request
How to fill out Form AF 2583, box by box
Identifying information
Enter 1. NAME (Last, First, Middle, Maiden) and 2. ORGANIZATION OR FIRM SPONSOR.
Enter 3. GRADE, 4. SSN and 5. CITIZENSHIP.
Enter 6. DATE OF BIRTH and 7. PLACE OF BIRTH (City, State, and Country).
Investigation, clearance, eligibility, entry and access requirements
Section II: investigation, clearance, eligibility, entry and access requirements: 8. investigation requirement and 9. clearance, entry or access requirement.
8. INVESTIGATION REQUIREMENT: National Agency Check and Inquiries (NACI), National Agency Check with Law and Credit (NACLC) or Access National Agency Check and Inquiries, Single Scope Background Investigation (SSBI), Secret Periodic Reinvestigation, and SSBI or PPR Periodic Reinvestigation.
9. Clearance, entry or access requirement: one-time access, limited access, interim clearance, special access, unescorted entry, top secret, secret and Priority Level 1, Priority Level 2, Priority Level 3 and Priority Level 4.
Local files check
In III. LOCAL FILES CHECK, enter the 10. TO box and the 11. FROM box.
Enter 12. DATE and 13. TYPED NAME, GRADE AND TITLE OF REQUESTER, and the requester signs 14. SIGNATURE.
Medical records check
In IV. MEDICAL RECORDS CHECK, 15. I CERTIFY a medical records check required by AFI 31-501 or its replacement has been completed and no information exists, unless shown in Section VII, which would preclude the granting of eligibility of security clearance, access to special programs or unescorted entry to restricted areas.
Enter 16. DATE, 17. TYPED NAME AND GRADE OF BASE DIRECTOR, MEDICAL SERVICES and 18. SIGNATURE.
Security police records check
In V. SECURITY POLICE RECORDS CHECK, 19. I CERTIFY a security police records check required by AFR 205-32, has been completed and no information exists, unless shown in Section VII, which would preclude the granting of a security clearance, unescorted entry to restricted areas, or access to special program classified information.
Enter 20. DATE, 21. TYPED NAME AND GRADE OF SECURITY POLICE OFFICIAL and 22. SIGNATURE.
Access authorization
VI. Access authorization: one-time access, limited access, CNWDI, NATO, RD, NC2-ESI, continuing and one-time.
23. I CERTIFY the named individual requires access to the special program(s) in Section VI, meets all investigative and clearance requirements, and has been briefed on program responsibilities as outlined in the governing directive. If applicable, emergency or limited access is necessary and will not endanger the national security.
Enter 24. DATE, 25. TYPED NAME, GRADE AND TITLE OF APPROVING AUTHORITY and 26. SIGNATURE.
Enter 27. DATE, 28. TYPED NAME, GRADE AND TITLE OF SPECIAL ACCESS PROGRAM CERTIFYING OFFICIAL and 29. SIGNATURE.
Remarks
In VII. REMARKS, enter 30 (If more space is needed, use reverse and show item number being continued).
More rules for Form AF 2583
It is used to request personnel security investigations, record emergency or limited access authorization, entry to restricted areas, and to record special access program authorizations.
The SSN is used for positive identification of the individual and records.
Sources
[1] Form AF 2583, Request for Personnel Security Action, Department of the Air Force (the Official source link on this page).