DEPARTMENT OF THE ARMY
(UNIT)
(MSC)
FORT CARSON, CO 80913
(OFFICE SYMBOL) DATE
MEMORANDUM FOR Physical Security Branch, ATTN: ICIDS Systems Administrator
SUBJECT: UNACCOMPANIED ACCESS ROSTER
1. UP of AR 190-11 the following individual(s) are authorized unaccompanied access and require a Personal Identification Cipher (PIC) to the arms room for ______(Unit)____________,
Building ______, Module ____ until officially relieved or released from assignment. Personnel noted below have been screened IAW AR 190-11, para 2-11 and have a valid DA Form 7281-R on file, a copy of which will be presented at the time of PIC issue.
NAMESSNRANKDUTY POSITIONOFF DUTY PHONE
Jones, Robert A.123-45-6789SPCPrimary Armorer(719) 555-5555
Snuffy, Thomas B.987-65-4321PFCAssistant Armorer(719) 555-5554
2. Contact phone during duty hours:
a. CQ:__________
b. Arms Room:__________
c. Supply Room:__________
d. Battalion Level SDO:__________
e. Brigade Level SDO:__________
3. This memorandum supersedes all other unaccompanied access rosters to this unit’s arms room as described above.
4. The point of contact for this memorandum is _______________, (Title)__________, duty hours phone __________, after hours phone __________.
DISTRIBUTION:COMMANDER SIGNATURE BLOCK
1-ICIDSCPT, INF
1-Arms Room Commanding
1-File