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  1.           WSMR DECSYSTEM-20 USERID REQUEST AND DIALUP AUTHORIZATION
  2.  
  3. 1. Requested Action (check one):  ___ NEW        ___ CHANGE        ___ CANCEL
  4.  
  5. 2. Printed Name of User:______________________________________________________
  6. ------------------------------------------------------------------------------
  7. 3. Organization Name and Mailing Address:        | 4. Office Phone Numbers:
  8.                                                  |
  9.                                                  | AV:
  10.                                                  | FTS:
  11.                                                  | CML:
  12. ------------------------------------------------------------------------------
  13.  
  14. 5. Userid/Mailbox name ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
  15.  
  16. ------------------------------------------------------------------------------
  17.  
  18. AR 380-380 prohibits users from revealing passwords to anyone, even though they
  19. may be employed on the same project and hold identical clearances.
  20.  
  21. ------------------------------------------------------------------------------
  22.  
  23. 6. Signature of User:________________________________________Date:____________
  24. ------------------------------------------------------------------------------
  25.  
  26. SUPERVISOR - I verify that this user is authorized to (check one or more):
  27.      ___ Use a DDN mailbox on the WSMR DECSYSTEM-20.
  28.      ___ Charge computer runs against a valid WSMR DECSYSTEM-20 project.
  29.      ___ Perform the duties of TASO IAW AR 380-380.
  30.  
  31. 7. Printed name of supervisor:________________________________________________
  32.  
  33. 8. Signature of Supervisor:__________________________________Date:____________
  34.  
  35. 9. Organization:_________________________________10. Phone:___________________
  36. ------------------------------------------------------------------------------
  37.  
  38. TASO: I verify that (check one):                                    
  39.      ___ This terminal user is authorized to use terminal equipment under my
  40.          jurisdiction.
  41.      ___ I am acting as own TASO and agree to perform the duties of TASO
  42.          IAW AR 380-380.
  43.  
  44. 11. Printed name of TASO:_____________________________________________________
  45.  
  46. 12. Signature of TASO:______________________________________Date:_____________
  47.  
  48. 13. Organization:_________________________________14. Phone:__________________
  49. ==============================================================================
  50.         THE SECTION BELOW TO BE FILLED IN BY WSMR DECSYSTEM-20 ADPSSO
  51. ------------------------------------------------------------------------------
  52. 15. Request No. | 16.  __                          __            __
  53.                 |     |__| Approved as Requested  |__| Changed  |__| Rejected
  54. ------------------------------------------------------------------------------
  55.  
  56. 17. Signature of ADPSSO:____________________________________Date:_____________
  57. 18. Comments:
  58.  
  59.  
  60. _______________________________________________________________________________
  61. STEWS-IM FORM 11 
  62. 1 Apr 87
  63.