The Department of Defense Form 3365, also known as the "CAC Application for CAC Services," is a form used to apply for a Common Access Card (CAC). The form can be used by both military and civilian personnel who need access to DoD computer systems. The application process is relatively simple, and can be completed online or through your local military installation. In order to complete the form, you will need some basic information about yourself, including your Social Security number, citizenship status, and date of birth. Once you have submitted the form, it will be reviewed by DoD personnel and you will be notified if your CAC has been approved.
| Question | Answer |
|---|---|
| Form Name | Da 3365 Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | Pers, V1, da form 3365, form |
AUTHORIZATION FOR MEDICAL WARNING TAG
For use of this form, see AR
TO: (Include ZIP Code) |
FROM: (Medical Treatment Facility (Specify Clinic, Ward, etc.)) |
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TYPED NAME AND SIGNATURE OF REQUESTING MEDICAL OR DENTAL OFFICER
DATE
LINE NO.
TAG CONTENT
SPACE NUMBER
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REMARKS
TAG DELIVERED TO PATIENT (Signature of Responsible Officer)
DATE DELIVERED
PERSON TO CALL IF OTHER THAN PATIENT
NAME AND RELATIONSHIP TO PATIENT
ADDRESS
PHONE NUMBER
PATIENT IDENTIFICATION
ORGANIZATION, UNIT, LOCATION (Military Pers ONLY) |
HOME ADDRESS (Include Zip Code) |
PHONE NUMBER |
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PATIENT'S NAME (Last, first, middle) |
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GRADE OR STATUS |
IDENTIFICATION NUMBER |
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DA FORM 3365, AUG 68
USAPA V1.01