{
  "url": "https://openlegislation.uk/eu-decision-2019-1963/annex-III/appendix-C",
  "json_url": "https://openlegislation.uk/eu-decision-2019-1963/annex-III/appendix-C.json",
  "legislation": "eudn/2019/1963",
  "legislation_title": "Commission Decision (EU, Euratom) 2019/1963 of 17 October 2019 laying down implementing rules on industrial security with regard to classified procurement contracts",
  "legislation_url": "https://openlegislation.uk/eu-decision-2019-1963",
  "path": "annex/III/appendix/C",
  "kind": "appendix",
  "number": "C",
  "heading": null,
  "text": "REQUEST FOR VISIT\n(MODEL)\nDetailed instructions for completion of request for visit\n(The application must be submitted in English only)\nHEADING\nCheck boxes for visit type, information type, and indicate how many sites are to be visited and the number of visitors.\n4.\nADMINISTRATIVE DATA\nTo be completed by requesting NSA/DSA.\n5.\nREQUESTING ORGANISATION OR INDUSTRIAL FACILITY\nGive full name and postal address.\nInclude city, state and post code as applicable.\n6.\nORGANISATION OR INDUSTRIAL FACILITY TO BE VISITED\nGive 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.\nRemarks:\n(1) Giving the correct post code (zip code) is important because a company may have various different facilities.\n(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).\n7.\nDATES OF VISIT\nGive 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.\n8.\nTYPE OF INITIATIVE\nSpecify whether the visit has been initiated by the requesting organisation or facility or by invitation of the facility to be visited.\n9.\nTHE VISIT RELATES TO:\nSpecify the full name of the project, contract or call for tender using commonly used abbreviations only.\n10.\nSUBJECT TO BE DISCUSSED/JUSTIFICATION\nGive a brief description of the reason(s) for the visit. Do not use unexplained abbreviations.\nRemarks:\nIn 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_____)\n11.\nANTICIPATED LEVEL OF CLASSIFIED INFORMATION TO BE INVOLVED\nState SECRET UE/EU SECRET (S-UE/EU-S)\nor\nCONFIDENTIEL UE/EU CONFIDENTIAL (C-UE/EU-C), as appropriate.\n12.\nPARTICULARS OF VISITOR\nRemark: when more than two visitors are involved in the visit, Annex 2 should be used.\n13.\nTHE SECURITY OFFICER OF THE REQUESTING ENTITY\nThis item requires the name, telephone number, fax number and email of the requesting facility’s Security Officer.\n14.\nCERTIFICATION OF SECURITY CLEARANCE\nThis field is to be completed by the certifying authority.\nNotes for the certifying authority:\n(a) Give name, address, telephone number, fax number and email (can be pre-printed).\n(b) This item should be signed and stamped (if applicable).\n15.\nREQUESTING SECURITY AUTHORITY\nThis field is to be completed by the NSA/DSA.\nNote for the NSA/DSA:\n(a) Give name, address, telephone number, fax number and email (can be pre-printed).\n(b) This item should be signed and stamped (if applicable).\nAll fields must be completed and the form submitted via Government-to-Government channels\nREQUEST FOR VISIT\n(MODEL)\nTo: _______________________________________\n1.\nTYPE OF VISIT REQUEST\n2.\nTYPE OF INFORMATION\n3.\nSUMMARY\n☐ Single\n☐ Recurring\n☐ Emergency\n☐ Amendment\n☐ Dates\n☐ Visitors\n☐ Facility\nFor an amendment, insert the NSA/DSA original RFV Reference No_____________\n☐ C-UE/EU-C\n☐ S-UE/EU-S\nNo of sites: _______\nNo of visitors: _____\n4.\nADMINISTRATIVE DATA:\nRequester:\nTo:\nNSA/DSA RFV Reference No________________\nDate (dd/mm/yyyy): _____/_____/_____\n5.\nREQUESTING ORGANISATION OR INDUSTRIAL FACILITY:\nNAME:\nPOSTAL ADDRESS:\nE-MAIL ADDRESS:\nFAX NO:\nTELEPHONE NO:\n6.\nORGANISATION(S) OR INDUSTRIAL FACILITY(IES) TO BE VISITED (Annex 1 to be completed)\n7.\nDATE OF VISIT (dd/mm/yyyy): FROM _____/_____/_____ TO _____/_____/_____\n8.\nTYPE OF INITIATIVE:\n☐ Initiated by requesting organisation or facility\n☐ By invitation of the facility to be visited\n9.\nTHE VISIT RELATES TO CONTRACT:\n10.\nSUBJECT TO BE DISCUSSED/REASONS/PURPOSE (Include details of host entity and any other relevant information. Abbreviations should be avoided):\n11.\nANTICIPATED HIGHEST CLASSIFICATION LEVEL OF INFORMATION/MATERIAL OR SITE ACCESS TO BE INVOLVED:\n12.\nPARTICULARS OF VISITOR(S) (Annex 2 to be completed)\n13.\nTHE SECURITY OFFICER OF THE REQUESTING ORGANISATION OR INDUSTRIAL FACILITY:\nNAME:\nTELEPHONE NO:\nE-MAIL ADDRESS:\nSIGNATURE:\n14.\nCERTIFICATION OF SECURITY CLEARANCE LEVEL:\nNAME:\nADDRESS:\nTELEPHONE NO:\nE-MAIL ADDRESS:\nSIGNATURE:\nDATE (dd/mm/yyyy): _____/_____/_____\n15.\nREQUESTING NATIONAL SECURITY AUTHORITY/DESIGNATED SECURITY AUTHORITY:\nNAME:\nADDRESS:\nTELEPHONE NO:\nE-MAIL ADDRESS:\nSIGNATURE:\nDATE (dd/mm/yyyy): _____/_____/_____\n16.\nREMARKS (Mandatory justification required in the case of an emergency visit):\n<Placeholder for reference to applicable personal data legislation and link to mandatory information to the data subject, e.g. how Article 13 of the General Data Protection Regulation is implemented.>",
  "extent": "E+W+S+N.I.",
  "status": null,
  "version": "current",
  "annotations": [
    {
      "type": "footnote",
      "label": "f1",
      "text": "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."
    },
    {
      "type": "footnote",
      "label": "f2",
      "text": "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)."
    }
  ],
  "outstanding_effects": [],
  "provenance": {
    "source": "legislation.gov.uk",
    "source_url": "https://www.legislation.gov.uk/eudn/2019/1963/annex/III/appendix/C",
    "retrieved_at": "2026-11-01T15:12:30.585648+00:00"
  },
  "licence": "Open Government Licence v3.0",
  "licence_url": "https://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/",
  "attribution": "Contains public sector information licensed under the Open Government Licence v3.0. Source: legislation.gov.uk, The National Archives."
}