System Authorization Access Request (SAAR) Form

To submit this form, you may electronically transmit it, fax it, or mail it to the appropriate department. Send your completed form to your supervisor for endorsement and to the security manager for validation. Ensure all required signatures are included. Email submissions should be sent to the provided official email address for processing. For specific submission details, follow the instructions provided by your organization's ISSO. We recommend maintaining a copy of the signed form for your records.

The OMB approval expires on 20250531. Ensure you comply with reporting requirements and submit the form before the expiration date.

The purpose of the System Authorization Access Request (SAAR) Form DD 2875 is to facilitate the process of authorizing access to Department of Defense (DoD) systems and information. This form helps in recording the personal, organizational, and security details of individuals requesting access. By filling out the form, individuals ensure that their access requests are validated and meet the necessary security clearance requirements.

• 1. Name: The last name, first name, and middle initial of the user.
• 2. Organization: The user's current organization.
• 3. Office Symbol/Department: The office symbol within the current organization.
• 4. Telephone Number/DSN: The Defense Switching Network (DSN) phone number of the user.
• 5. Official E-mail Address: The user's official e-mail address.
• 6. Job Title/Grade/Rank: The civilian job title or military rank of the user.
• 7. Official Mailing Address: The user's official mailing address.
• 8. Citizenship: Indication of US, Foreign National, or Other.
• 9. Designation of Person: Indication of Military, Civilian, or Contractor.
• 10. IA Training and Awareness Certification Requirements: Indication of completion of Annual Cyber Awareness Training and the date.
• 11. User's Signature: User's signature indicating responsibility and accountability for access to the system.
• 12. Date: The date the user signs the form.
• 13. Justification for Access: A brief statement justifying the establishment or modification of a USER ID.
• 14. Type of Access Required: Indicator for authorized or privileged access to the system.
• 15. User Requires Access To: Specification of the category of access required.
• 16. Verification of Need to Know: Verification indicating the user's necessity for access.
• 17. Expiration Date for Access: Specification of the expiration date if less than 1 year.
• 18. Supervisor's Name: The printed name of the supervisor verifying the above information.
• 19. Supervisor's E-mail Address: Supervisor's e-mail address.
• 20. Supervisor's Phone Number: Supervisor's telephone number.
• 21. Supervisor's Organization/Department: Supervisor's organization and department.
• 22. Supervisor's Signature: Supervisor's signature endorsing the access request.
• 23. Supervisor's Date: The date the supervisor signs the form.
• 24. Functional Appointee Telephone Number: Functional appointee telephone number.
• 25. Signature of Information Owner/Office of Primary Responsibility (OPR): Signature of the Information Owner or functional appointee approving access.
• 26. Date: The date the functional appointee signs the form.
• 27. ISSO's Organization/Department: Information Systems Security Officer's organization and department.
• 28. ISSO's Telephone Number: Information Systems Security Officer's telephone number.
• 29. Signature of the ISSO/Appointee: Signature of the ISSO or Appointee responsible for approving access.
• 30. Date: The date the ISSO or Appointee signs the form.
• 31. Optional Information: Field for adding additional information as required.
• 32. Type of Investigation: The user's last type of background investigation.
• 33. Investigation Date: Date of the user's last investigation.
• 34. Continuous Evaluation (CE) Deferred Investigation: Indication of whether the user is enrolled for 'Deferred Investigation' in the Continuous Evaluation (CE) program.
• 35. Continuous Evaluation Enrollment Date: Date of CE enrollment.
• 36. Access Level: The access level granted to the user.
• 37. Verified By: Printed name of the Security Manager or representative verifying the clearance and investigation information.
• 38. Verification Date: Date the Security Manager performed the background investigation and clearance information verification.
• 39. System Information: Site specific information for identifying the access required by the user.
• 40. Disposition of Form: Instructions for the transmission and maintenance of the original form.

Failure to submit this form may result in delayed access to the necessary systems and information. It can also impede the verification of your background and clearance.

• Access Delay: Delays in gaining the required access to perform official duties.
• Verification Issues: Inability to verify background and clearance information.
• Processing Hold-ups: Impeding the processing of requests for system access.

• 1. Initial Access Request: For new users seeking access to a DoD system.
• 2. Modification of Access: For users who need to update or change their existing access permissions.
• 3. Supervisor Endorsement: To be completed by supervisors endorsing access requests.
• 4. Security Validation: For security managers validating the user's background and clearance.
• 5. Contractor Access Request: For contractors needing access to DoD systems as part of their contract.