Appendix C

United Kingdom

REQUEST FOR VISIT

(MODEL)

Detailed instructions for completion of request for visit

(The application must be submitted in English only)

HEADING	Check boxes for visit type, information type, and indicate how many sites are to be visited and the number of visitors.
4. ADMINISTRATIVE DATA	To be completed by requesting NSA/DSA.
5. REQUESTING ORGANISATION OR INDUSTRIAL FACILITY	Give full name and postal address. Include city, state and post code as applicable.
6. ORGANISATION OR INDUSTRIAL FACILITY TO BE VISITED	Give full name and postal address. Include city, state, post code, telex or fax number (if applicable), telephone number and email. Give the name and telephone/fax numbers and email of your main point of contact or the person with whom you have made the appointment for the visit. Remarks: (1) Giving the correct post code (zip code) is important because a company may have various different facilities. (2) When applying manually, Annex 1 can be used when two or more facilities have to be visited in connection with the same subject. When an Annex is used, item 3 should state: ‘SEE ANNEX 1, NUMBER OF FAC: …’ (state number of facilities).
7. DATES OF VISIT	Give the actual date or period (date-to-date) of the visit in the format ‘day — month — year’. Where applicable, give an alternate date or period in brackets.
8. TYPE OF INITIATIVE	Specify whether the visit has been initiated by the requesting organisation or facility or by invitation of the facility to be visited.
9. THE VISIT RELATES TO:	Specify the full name of the project, contract or call for tender using commonly used abbreviations only.
10. SUBJECT TO BE DISCUSSED/JUSTIFICATION	Give a brief description of the reason(s) for the visit. Do not use unexplained abbreviations. Remarks: In the case of recurring visits this item should state ‘Recurring visits’ as the first words in the data element (e.g. Recurring visits to discuss_____)
11. ANTICIPATED LEVEL OF CLASSIFIED INFORMATION TO BE INVOLVED	State SECRET UE/EU SECRET (S-UE/EU-S) or CONFIDENTIEL UE/EU CONFIDENTIAL (C-UE/EU-C), as appropriate.
12. PARTICULARS OF VISITOR	Remark: when more than two visitors are involved in the visit, Annex 2 should be used.
13. THE SECURITY OFFICER OF THE REQUESTING ENTITY	This item requires the name, telephone number, fax number and email of the requesting facility’s Security Officer.
14. CERTIFICATION OF SECURITY CLEARANCE	This field is to be completed by the certifying authority. Notes for the certifying authority: (a) Give name, address, telephone number, fax number and email (can be pre-printed). (b) This item should be signed and stamped (if applicable).
15. REQUESTING SECURITY AUTHORITY	This field is to be completed by the NSA/DSA. Note for the NSA/DSA: (a) Give name, address, telephone number, fax number and email (can be pre-printed). (b) This item should be signed and stamped (if applicable).

All fields must be completed and the form submitted via Government-to-Government channels^f1

REQUEST FOR VISIT (MODEL) To: _______________________________________
1. TYPE OF VISIT REQUEST	2. TYPE OF INFORMATION	3. SUMMARY
☐ Single ☐ Recurring ☐ Emergency ☐ Amendment ☐ Dates ☐ Visitors ☐ Facility For an amendment, insert the NSA/DSA original RFV Reference No_____________	☐ C-UE/EU-C ☐ S-UE/EU-S	No of sites: _______ No of visitors: _____
4. ADMINISTRATIVE DATA:
Requester: To:	NSA/DSA RFV Reference No________________ Date (dd/mm/yyyy): _____/_____/_____
5. REQUESTING ORGANISATION OR INDUSTRIAL FACILITY:
NAME: POSTAL ADDRESS: E-MAIL ADDRESS: FAX NO:	TELEPHONE NO:
6. ORGANISATION(S) OR INDUSTRIAL FACILITY(IES) TO BE VISITED (Annex 1 to be completed)
7. DATE OF VISIT (dd/mm/yyyy): FROM _____/_____/_____ TO _____/_____/_____
8. TYPE OF INITIATIVE: ☐ Initiated by requesting organisation or facility ☐ By invitation of the facility to be visited
9. THE VISIT RELATES TO CONTRACT:
10. SUBJECT TO BE DISCUSSED/REASONS/PURPOSE (Include details of host entity and any other relevant information. Abbreviations should be avoided):
11. ANTICIPATED HIGHEST CLASSIFICATION LEVEL OF INFORMATION/MATERIAL OR SITE ACCESS TO BE INVOLVED:
12. PARTICULARS OF VISITOR(S) (Annex 2 to be completed)
13. THE SECURITY OFFICER OF THE REQUESTING ORGANISATION OR INDUSTRIAL FACILITY: NAME: TELEPHONE NO: E-MAIL ADDRESS: SIGNATURE:
14. CERTIFICATION OF SECURITY CLEARANCE LEVEL:
NAME: ADDRESS: TELEPHONE NO: E-MAIL ADDRESS:
SIGNATURE:	DATE (dd/mm/yyyy): _____/_____/_____
15. REQUESTING NATIONAL SECURITY AUTHORITY/DESIGNATED SECURITY AUTHORITY:
NAME: ADDRESS: TELEPHONE NO: E-MAIL ADDRESS:
SIGNATURE:	DATE (dd/mm/yyyy): _____/_____/_____
16. REMARKS (Mandatory justification required in the case of an emergency visit):

Annotations

Footnotes

f1: If it has been agreed that visits involving access or potential access to EUCI at CONFIDENTIEL UE/EU CONFIDENTIAL and SECRET UE/EU SECRET level can be arranged directly, the completed form can be submitted directly to the Security Officer of the establishment to be visited.
f2: Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46/EC (General Data Protection Regulation) (OJ L 119, 4.5.2016, p. 1).