Download This form is to be completed by an Agency Security Advisor or

SVA 016
UNCLASSIFIED
Request for Security Officer Dashboard
Access
This form is to be signed by the nominated security officer and
endorsed by a Commonwealth employee at the level of EL1 or
above or a member of the Australian Defence Force at the level of
Commander, Lt Colonel, Wing Commander or above.
All fields are mandatory unless indicated otherwise.
ASA/ASD
To: Australian Government Security Vetting Agency
Email: [email protected]
Mail: Department of Defence - AGSVA CP3-4-075 PO Box 7951
CANBERRA BC 2610
Instructions for completion
This form requests the Australian Government Security Vetting Agency (AGSVA) to provide the person identified in
Section 1 with the access to the Security Officer Dashboard required to request security clearances and other services
from AGSVA. This form is also used to advise the AGSVA when a new security officer is replacing an existing security
officer.
Section 1 Request access: provide details of the new security officer who requires access to the Security Officer
Dashboard, including the Defence sponsor group and section or DISP company in which they operate.
Section 2 Only to be completed if the new security officer is replacing an existing security officer.
Note: The existing security officer being replaced will lose all access to the Security Officer Dashboard upon completion
of processing this request.
Section 3 To be signed by the new security officer who requires access and endorsed by a Commonwealth employee at the
level of EL1 or above or a member of the Australian Defence Force at the level of Commander, Lt Colonel, Wing
Commander or above.
Section 1 –Details of the new security officer requiring access
Family name
Title
Given names
Date of birth
Email
Security
clearance level
Phone
Army
Air Force
Navy
DISP Company*
Army Reserves
Air Force Reserves
Navy Reserves
APS Agency*
Sponsor Group
* DISP
Company or
APS Agency
Action
required
New access request
*Section 2 – Details of the existing security officer being replaced and removed* (only complete if relevant)
Family name
Title
Given names
Date of birth
Email
Security
clearance level
Phone
Army
Air Force
Navy
DISP Company*
Army Reserves
Air Force Reserves
Navy Reserves
APS Agency*
Sponsor Group
* DISP
Company or
APS Agency
*Note the existing security officer to be replaced and removed must be registered with the AGSVA.
Version: 1.2 May 2017
UNCLASSIFIED
SVA 016 Page 1 of 2
SVA 016
UNCLASSIFIED
Request for Security Officer Dashboard
Access
ASA/ASD
Section 3 – Applicant signature and endorsement
Access to the Security Officer Dashboard is granted at the discretion of the AGSVA. Access is granted on a ‘need to know, need to
hold’ basis. Individuals granted access to the Security Officer Dashboard must only access the Security Officer Dashboard, and
access, use or disclose data contained on the Security Officer Dashboard in accordance with their duties as a member of the
Australian Defence Force, Australian Public Service, or in accordance with the terms of their contract for service with the
Commonwealth Government.
Unauthorised access to, use or disclosure of data contained on the Security Officer Dashboard is a breach of the Privacy Act 1988
and may also constitute an offence under section 70 (Disclosure of information by Commonwealth officers), or section 79 (Official
Secrets) of the Crimes Act 1914 (Cth).
Criminal or disciplinary action may be taken against an individual for any unauthorised access, use or disclosure under the Crimes
Act 1914 (Cth), the Defence Force Discipline Act 1982 (Cth), and / or the Public Service Act 1999 (Cth) respectively.
II have read and understood the conditions of access to the Security Officer Dashboard. I agree to comply with these
conditions of access and understand that action may be taken against me for any unauthorised access, use of or
disclosure of data contained on the Security Officer Dashboard.
Applicant
Signature
Date
Note: Signature is mandatory
EL1, Commander, Lt Colonel, Wing Commander (or above) endorsement
I agree that the person nominated above is required to have access to the Security Officer Dashboard for their
security officer duties and authorise the AGSVA to create a profile and logon for them.
Date
Name
Email
Rank/title
Signature
Note: Signature is mandatory
AGSVA Use Only
VID / CSID
Authorising Officer
PMKeyS /
Employee ID
Version: 1.2 May 2017
Date actioned
Signature
UNCLASSIFIED
SVA 016 Page 2 of 2