DD Form 2875

A DD 2875 Form is used by the Department of Defense (DOD) to determine whether someone will receive access to certain systems. Known as a System Authorization Access Request, it is used to request access to certain DOD systems and information. This form may be used to request initial access, modify existing access, or to revoke access. The individual requesting access must provide certain personal information and sign the form.

What is a DD Form 2875?

A DD Form 2875 will be used by the Department of Defense. This form is known as a System Authorization Access Request. The form is used to validate the trustworthiness of the individuals who are requesting access to the Department of Defense systems and information.
The person using this form will need to list the type of request, whether it is an initial request, a modification, or deactivation. The requester will then need to list their personal information so that their identity can be verified.
An endorsement for access must be provided from the owner of the information, a supervisor, or a government sponsor. This person will also need to provide their personal identifying information, and they will need to sign the form.

How to complete a DD Form 2875 (Step by Step)

To complete a DD Form 2875, you need to provide the following information:

  • Type of request: initial, modification, deactivate, user ID
  • Date
  • System name
  • Location
  • Part I - To be completed by Requestor
    • Name
    • Organization
    • Office symbol/department
    • Phone
    • Official email address
    • Job title and grade/rank
    • Official mailing address
    • Citizenship: US, FN, other
    • Designation of person: military, civilian, contractor
    • IA training and awareness certification requirements
    • User signature
    • Date
  •  Part II - Endorsement of access by information owner, user supervisor, or government sponsor
    • Justification for access
    • Type of access required
    • Access to classified or unclassified required
    • Verification of need to know
    • Access expiration date
    • Supervisor’s name
    • Supervisor’s signature
    • Supervisor’s organization/department
    • Supervisor’s email address
    • Phone number
    • Signature of information owner/OPR
    • Phone number
    • Date
    • Signature of IAO or appointee
    • Organization/department
    • Phone number
    • Date
    • Optional information
  • Part III - Security Manager Validates the Background Investigation or Clearance Information
    • Type of investigation
    • Date of investigation
    • Clearance level
    • IT level designation
    • Verified by
    • Security manager telephone number
    • Security manager signature
    • Date
  • Part IV - Completion by Authorized Staff Preparing Account Information
    • Title
    • System
    • Account Code
    • Domain
    • Server
    • Application
    • Directories
    • Files
    • Datasets
    • Date processed 
    • Processed by
    • Date
    • Date revalidated
    • Revalidated by
    • Date

Form may be electronically transmitted, faxed, or mailed.

Sample DD Form 2875


Sample DD Form 2875

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