Defense User Registration System (DURS) Records

Defense User Registration System (DURS) Records

PrivacyActStatement_RegistrationForm_14Sep2015

Defense User Registration System (DURS) Records

OMB: 0704-0546

Document [pdf]
Download: pdf | pdf
Create an Account

Creating an Account... Step 1

Register with Smart Card
IMPORTANT: When prompted, select a PKI certificate that
has an e-mail address.
DoD CAC

...or with Email
Enter your email address

Continue….
Privacy Act Statement
AUTHORITY: 5 U.S.C. 301, Departmental Regulations; E.O. 13526, Classified National Security Information;
DoDM 5200.01-Volume 3, DoD Information Security Program: Protection of Classified Information; DoD 5200.2-R,
Personnel Security Program.
PURPOSE: To identify individuals who apply for, and are granted, access privileges to DTIC products and electronic
information systems.
ROUTINE USES: Information is used for the purpose set forth above and may be disclosed outside the DoD pursuant
to the "Blanket Routine Uses" set forth at the beginning of the OSD's compilation of Systems of Records Notices.
DISCLOSURE: Voluntary, but failure to provide the requested personal information may prevent the individual from
gaining access to DTIC's controlled information services.
To read the full content of the DTIC System of Records Notice (SORN), click here.
Privacy Impact Assessment, (PIA). click here

Agency Disclosure Notice
The public reporting burden for this collection of information is estimated to average 10 minutes per response, including the
time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing
and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing the burden, to the Department of Defense, Washington
Headquarters Services, Executive Services Directorate, Information Management Division, 4800 Mark Center Drive, East
Tower, Suite 02G09, Alexandria, VA 22350-3100. Respondents should be aware that notwithstanding any other provision of
law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a
currently valid OMB control number
OMB CONTROL NUMBER: XXXX-XXXX [placeholder]
OMB EXPIRATION DATE: XX/XX/XXXX [placeholder
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Create an Account (Step 4)

Account Creation... Step 4
For Contractor, Potential Contractor, and Non-DoD Government Personnel
OMB Control Number [placeholder]

Expiration date [placeholder]

Asterisk (*) denotes required fields

Instructions

General Information

Password

First Name*

Middle Initial

Password* 

Last Name*

Title

Re-enter Password*

U. S. Citizen*

Organization *

Password Reset Question*

Yes

No

Password Reset Answer*

Email Address*

Phone/Fax
Commercial Phone *

Commercial Fax

DSN Phone

DSN Fax

Organization/Company Mailing Address
Office Symbol (Attention)

City*

Street Address 1*

State*

select - -- select
Street Address 2

ZIP Code*

Street Address 3

Country*

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Create an Account (Step 4)

UNITED STATES
UNITED
STATES

Contract Information (Contractors ONLY)
Prime Contract Number*

MCTDA Number 

Cage Code 

Contract Classification*

MCTDA Exp Date 

Contract Expiration Date *

- -- select
select

Type of Access Required
✔

Public Release
Only

✔

Unclassified/Limited

U.S. Government Approving Official (GAO)
First Name *

Phone Number *

Last Name *

- select Email *

Organization *

Create Account

« Start Over

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File Typeapplication/pdf
File TitleCreate an Account
File Modified2015-09-21
File Created2015-06-01

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