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Scope of Authorization: Subject to the limitations that follow, the POC is authorized to grant individuals access to the Transportation Security Administration (TSA) September 11th Security Fee Reporting Application to submit quarterly security fee reports for the carrier named above. This authorization contains no implied authorization to access any other computer system of the U.S. Government, and will be revoked on separation, retirement, reassignment of duties, change of organization or when determined by the Information Systems Security Officer to be in the best interest of the Government. WARNING: Only Authorized Users May Use These Systems. To protect these systems from unauthorized use and to ensure that these systems are functioning properly, system administrators monitor these systems. Individuals using these systems without authority, or in excess of their authority, are subject to having all of their activities on these systems monitored and recorded by system personnel. In the course of monitoring individuals improperly using these systems, or in the course of system maintenance, the activities of authorized users may also be monitored. Anyone using these systems expressly consents to such monitoring and is advised that if such monitoring reveals possible evidence of criminal activity, management may authorize system personnel to provide the evidence of such monitoring to law enforcement officials.
Name: __________________________________________ Date: __________________________
Send the completed form to:
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