Dot F 1681 Form PDF Details

In the realm of securing and managing access to federal facilities and information systems, the DOT F 1681 form plays a critical role. This comprehensive document serves as an application for Identification Cards or Credentials, catering specifically to the needs of employees and contractors within the Department of Transportation and its associated administrations and agencies. The form covers a wide array of applicant data, including personal information, organizational segment, citizenship, and the specifics of the ID card or credential being requested—be it for new issuance, replacement due to loss, damage, or expiration, or for other specified reasons. Moreover, it details the process for credential justification, encompassing executive and other official positions that necessitate such identification for the execution of duties. Integral to the application process are the steps for identity verification and security clearance, which include document examination, fingerprinting, and background checks. Subsequent sections of the form outline procedural directives for sponsors, registrars, trusted agents, and issuers to ensure that the applicant’s information is thoroughly vetted and correctly entered into the ID system. The form also underscores the responsibilities of the cardholder, emphasizing the importance of safeguarding the document against damage, loss, or unauthorized use, and stipulates procedures for reporting and replacing lost or stolen cards. By capturing every pertinent detail from application to issuance and acknowledgment of receipt, the DOT F 1681 form underscores the federal government’s commitment to security, accountability, and the responsible management of access to its resources.

QuestionAnswer
Form NameDot F 1681 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesdot f 1681 form, https idms faa dot 1681, dot f 1681, dot form 1681 pdf

Form Preview Example

Identification Card / Credential Application

Applicant Data

Application for

X

Identification Card or

Credentials

ID Card Number:

(To be completed by Issuer)

Last Name

 

First Name

Middle Name

 

Social Security Number

 

 

 

Org. Seg. (OST only)

 

 

 

 

 

M

F

DOT Administration/Agency

 

 

 

 

 

 

 

Line of Business (FAA only)

 

Date/Place of Birth

 

Sex (M/F)

 

ft.

in.

lbs.

 

 

 

 

 

 

 

Height

 

Weight

Hair Color

 

 

Eye Color

 

Citizenship

 

Office Routing Symbol

Office Phone Number(s)

Issuing office use

Office e-mail address

Office (Street) Address

- - - - - - - Contractors Only - - - - - - -

Contractor Company

Contract Number & Expiration Date

Contracting Officer Name and Phone Number (printed)

- - - - - - - Reason for Issuance- - - - - - -

X New ID Card or Credential

Lost

Damaged

Stolen

Expired

Other (Specify):

- - - - - - - Application for Credentials Only- - - - - - -

New Credential Request

Type:

Executive

Official

Other

Position title to appear on the credential

Credential Justification/Remarks

- - - - - - - Applicant Signature- - - - - - -

Employee Type

Other:

Permanent

Contractor

Temporary

Signature of Applicant

Date of Application

- - - - - - - Information below to be filled out by the Sponsor - - - - - - -

Expiration Date of ID Card

Type of Card:

Permanent Other

Temporary (Specify):

Sponsor’s Name & Phone Number (Typed or Printed)

Routing Symbol

Date

Sponsor’s Signature

- - - - - - - Identity Verification Information below to be filled out by the Registrar or Trusted Agent (TA) - - - - - - -

Applicant’s identity

documents have been

Applicant has submitted all

Applicant has been fingerprinted

Applicant’s picture for ID has been taken

examined

investigation paperwork (if required)

Registrar’s/ TA’s Name (Typed or Printed)

Routing Symbol

Date

Registrar’s/TA’s Signature

- - - - - - - Information below to be filled out by the Registrar - - - - - - -

Individual is authorized to be issued the following ID type

Permanent

Temporary

Other:

Individual has a completed and favorably adjudicated

NAC

NACI or higher

FBI Fingerprint Check

Other:

Registrar’s Name (Typed or Printed)

Routing Symbol

Date

Registrar’s Signature

- - - - - - - Information below to be filled out by the Issuer - - - - - - -

DOT F 1681 is correctly completed.

Applicant’s information in the ID system is correct.

Issuer’s Name (Typed or Printed)

Routing Symbol

Date

Issuer’s Signature

- - - - - - - Applicant’s Acknowledgement Receipt - - - - - - -

Your card contains data that may be used to verify your identity. You must exercise care in handling your card. Do not bend or twist it, expose it to extreme heat or cold. You may keep the card only for as long as you are authorized to enter Federal buildings or have access to Federal information systems. You must return the card when you no longer need it, or upon demand by the government or your employer. You must inform your supervisor, your security representative, and/or the organization that issued your card if it is lost or stolen. You may be asked to wait for a period of time before a replacement card is issued. Please acknowledge receipt of your card and that you accept your responsibilities regarding its use and safeguarding by signing your name below.

Applicant’s Signature

DOT F 1681 (test – 12/01/05)

Date

Privacy Act Notice:

The information on this form is requested under authority of Titles 5 and 49, USC; Title 32, CFR; and Title 40 USC 486c. Submission of all data is mandatory in order to receive DOT identification media. The purpose is to provide a ready concentration of employee personal data to facilitate issuance, accountability, and recovery of required identification/credential card(s) which are issued to employees/contractors. The information provided will be used to issue such identification/credential card(s) as may be required to enable the employee or contractor to properly conduct assigned duties. Failure to provide all or any part of the requested data will result in your inability to be properly identified and, therefore, be unable to properly perform all aspects of your assigned official duties.

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1. While completing the dot form 1681 online, ensure to complete all of the necessary blank fields in its associated form section. This will help to speed up the process, making it possible for your information to be handled quickly and accurately.

dot form 1681 conclusion process explained (portion 1)

2. Once your current task is complete, take the next step – fill out all of these fields - Applicant Signature, Employee Type, Permanent, Contractor, Temporary, Signature of Applicant, Date of Application, Other, Expiration Date of ID Card, Information below to be, Type of Card, Permanent, Temporary, Other Specify, and Sponsors Name Phone Number Typed with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Completing part 2 of dot form 1681

Concerning Permanent and Expiration Date of ID Card, be certain you double-check them here. The two of these are certainly the key fields in this document.

3. This next segment is about Your card contains data that may, DOT F test, Applicants Signature, Date, Privacy Act Notice, and The information on this form is - fill out every one of these empty form fields.

Filling out segment 3 of dot form 1681

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