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