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U.S. DOD Form dod-da-5440-a APPROVAL OF CLINICAL PRIVILEGES/STAFF APPOINTMENT For use of this form, see AR 40-68; the proponent agency is OSG. 4. EFFECTIVE PERIOD (YYYYMMDD) 1. NAME OF PROVIDER (Last,
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Fill in your personal information in the designated spaces. This may include your name, address, social security number, and contact information.
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Provide any relevant details about your military service, such as your branch, rank, and dates of service. If you are not in the military, you may skip this section.
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What is us dod form dod-da-5440-a?
US DoD form DoD-DA-5440-A is a form used by the Department of Defense to collect information about individuals who are seeking access to classified information.
Who is required to file us dod form dod-da-5440-a?
Individuals who are seeking access to classified information are required to file US DoD form DoD-DA-5440-A.
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To fill out US DoD form DoD-DA-5440-A, you need to provide personal information, employment history, and details about your security clearance.
What is the purpose of us dod form dod-da-5440-a?
The purpose of US DoD form DoD-DA-5440-A is to gather information necessary for the Department of Defense to assess an individual's eligibility for access to classified information.
What information must be reported on us dod form dod-da-5440-a?
US DoD form DoD-DA-5440-A requires information such as personal details, employment history, education background, criminal record, and references.
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