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The OPNAV 5239/14 form, also known as the System Authorization Access Request for Navy (SAAR-N), serves a crucial function in the verification and management of access to Department of Defense (DoD) information systems. It operates under several legal authorities and guidelines, including Executive Order 10450 and the Computer Fraud and Abuse Act, ensuring that individuals accessing sensitive information are properly vetted. The primary purpose of this form is to record user identification, which helps verify the identities of those requesting access to various DoD systems. It involves several key sections that capture essential information, including the requester's personal details, job title, and organization. Additionally, it requires endorsements from supervisors or government sponsors to validate the justification for access. The form also outlines user responsibilities and the conditions for consent, emphasizing security protocols and the importance of safeguarding DoD information. Users must indicate their citizenship and designation, declare their completion of Information Assurance Awareness Training, and articulate the type of access needed—authorized or privileged. The process ensures that personal identifiable information (PII) is collected and handled with care, reflecting the Navy's commitment to security and information protection.

5239 14 Example

FOR OFFICIAL USE ONLY WHEN FILLED

SYSTEM AUTHORIZATION ACCESS REQUEST NAVY (SAAR-N)

PRIVACY ACT STATEMENT

AUTHORITY: Executive Order 10450, Public Law 99-474, the Computer Fraud and Abuse Act; and System of Records Notice: NM0500-2 Program Management and Locator System.

PRINCIPAL PURPOSE: To record user identification for the purpose of verifying the identities of individuals requesting access to Department of Defense (DOD) systems and information.

ROUNTINE USES: The collection of data is used by Navy Personnel Supervisors/Managers, Administration Office, Security Managers, Information Assurance Managers, and System Administration with a need to know.

DISCLOSURE: Disclosure of this information is voluntary; however, failure to provide the requested information may impede, delay or prevent further processing of this request.

TYPE OF REQUEST:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE (DDMMMYYYY):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INITIAL

 

MODIFICATION

 

 

DEACTIVATE

 

 

USER ID

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SYSTEM NAME (Platform or Application):

 

 

 

 

 

 

 

 

 

 

 

 

LOCATION (Physical Location of System):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PART I (To be completed by Requester)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.

NAME (Last, First, Middle Initial):

 

 

 

 

 

 

 

 

 

 

 

 

2. ORGANIZATION:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

OFFICE SYMBOL/DEPARTMENT:

 

 

 

 

 

 

 

 

 

 

 

 

4. PHONE (DSN and Commercial):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DSN:

 

 

 

 

COM:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5.

OFFICIAL E-MAIL ADDRESS:

 

 

6. JOB TITLE AND GRADE/RANK:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7.

OFFICIAL MAILING ADDRESS:

 

 

8. CITIZENSHIP:

 

 

 

 

 

 

 

9. DESIGNATION OF PERSON

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CIVILIAN

 

 

 

 

 

 

 

 

 

 

US

 

 

 

 

FN

 

 

 

MILITARY

 

 

 

 

 

 

 

 

 

 

 

LN

 

 

Other

 

 

 

CONTRACTOR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10. INFORMATION ASSURANCE (IA) AWARENESS TRAINING REQUIREMENTS (Complete as required for user or functional level access.):

 

I have completed Annual IA Awareness Training.

 

 

DATE (DDMMMYYYY):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PART II - ENDORSEMENT OF ACCESS BY INFORMATION OWNER, USER SUPERVISOR OR GOVERNMENT SPONSOR (If an individual is a contractor - provide company name, contract number, and date of contract expiration in Block 14a).

11. JUSTIFICATION FOR ACCESS:

12. TYPE OF ACCESS REQUIRED:

 

AUTHORIZED

 

PRIVILEGED

12a. If Block 12 is checked "Privileged", user must sign a

DATE SIGNED (DDMMMYYYY):

 

Privileged Access Agreement Form.

 

13.

USER REQUIRES ACCESS TO:

 

 

 

 

 

 

UNCLASSIFIED

CLASSIFIED (Specify Category):

 

 

OTHER:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14.

VERIFICATION OF NEED TO KNOW:

 

14a. ACCESS EXPIRATION DATE (Contractors must specify Company Name, Contract

 

 

Number, Expiration Date):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I certify that this user requires access as requested.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15. SUPERVISOR'S ORGANIZATION/DEPARTMENT:

15a. SUPERVISOR'S E-MAIL ADDRESS:

15b. PHONE NUMBER:

16. SUPERVISOR'S NAME (Print Name):

16a. SUPERVISOR'S SIGNATURE

16b. DATE (DDMMMYYYY):

17. SIGNATURE OF INFORMATION OWNER/OPR:

17a. PHONE NUMBER:

17b. DATE (DDMMMYYYY):

18. SIGNATURE OF IAM OR APPOINTEE:

19. ORGANIZATION/DEPARTMENT:

20. PHONE NUMBER:

21.DATE (DDMMMYYYY):

OPNAV 5239/14 (Rev 9/2011)

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REPLACES (Rev 7/2008), WHICH IS OBSOLETE FOR OFFICIAL USE ONLY WHEN FILLED

 

FOR OFFICIAL USE ONLY WHEN FILLED

22. USER AGREEMENT - STANDARD MANDATORY NOTICE AND CONSENT PROVISION:

By signing this document, you acknowledge and consent that when you access Department of Defense (DoD) information systems:

-You are accessing a U.S. Government (USG) information system (IS) (which includes any device attached to this information system) that is provided for U.S. Government-authorized use only.

-You consent to the following conditions:

The U.S. Government routinely intercepts and monitors communications on this information system for purposes including, but not limited to, penetration testing, communications security, (COMSEC) monitoring, network operations and defense, personnel misconduct (PM), law enforcement (LE) and counterintelligence (CI) investigations.

At any time, the U.S. Government may inspect and seize data stored on this information system.

Communications using, or data stored on, this information system are not private, are subject to routine monitoring, interception and search, and may be disclosed or used for any U.S. Government-authorized purpose.

This information system includes security measures (e.g., authentication and access controls) to protect U.S. Government interests--not for your personal benefit or privacy.

Notwithstanding the above, using an information system does not constitute consent to personnel misconduct, law enforcement, or counterintelligence investigative searching or monitoring of the content of privileged communications or data (including work product) that are related to personal representation or services by attorneys, psychotherapists, or clergy, and their assistants. Under these circumstances, such communications and work product are private and confidential, as further explained below:

-Nothing in this User Agreement shall be interpreted to limit the user's consent to, or in any other way restrict or affect, any U.S. Government actions for purposes of network administration, operation, protection, or defense, or for communications security. This includes all communications and data on an information system, regardless of any applicable privilege or confidentiality.

-The user consents to interception/capture and seizure of ALL communications and data for any authorized purpose (including personnel misconduct, law enforcement, or counterintelligence investigation). However, consent to interception/capture or seizure of communications and data is not consent to the use of privileged communications or data for personnel misconduct, law enforcement, or counterintelligence investigation against any party and does not negate any applicable privilege or confidentiality that otherwise applies.

-Whether any particular communication or data qualifies for the protection of a privilege, or is covered by a duty of confidentiality, is determined in accordance with established legal standards and DoD policy. Users are strongly encouraged to seek personal legal counsel on such matters prior to using an information system if the user intends to rely on the protections of a privilege or confidentiality.

-Users should take reasonable steps to identify such communications or data that the user asserts are protected by any such privilege or confidentiality. However, the user's identification or assertion of a privilege or confidentiality is not sufficient to create such protection where none exists under established legal standards and DoD policy.

-A user's failure to take reasonable steps to identify such communications or data as privileged or confidential does not waive the privilege or confidentiality if such protections otherwise exist under established legal standards and DoD policy. However, in such cases the U.S. Government is authorized to take reasonable actions to identify such communication or data as being subject to a privilege or confidentiality, and such actions do not negate any applicable privilege or confidentiality.

-These conditions preserve the confidentiality of the communication or data, and the legal protections regarding the use and disclosure of privileged information, and thus such communications and data are private and confidential. Further, the U.S. Government shall take all reasonable measures to protect the content of captured/seized privileged communications and data to ensure they are appropriately protected.

In cases when the user has consented to content searching or monitoring of communications or data for personnel misconduct, law enforcement, or counterintelligence investigative searching, (i.e., for all communications and data other than privileged communications or data that are related to personal representation or services by attorneys, psychotherapists, or clergy, and their assistants), the U.S. Government may, solely at its discretion and in accordance with DoD policy, elect to apply a privilege or other restriction on the U.S. Government's otherwise-authorized use or disclosure of such information.

All of the above conditions apply regardless of whether the access or use of an information system includes the display of a Notice and Consent Banner ("banner"). When a banner is used, the banner functions to remind the user of the conditions that are set forth in this User Agreement, regardless of whether the banner describes these conditions in full detail or provides a summary of such conditions, and regardless of whether the banner expressly references this User Agreement.

USER RESPONSIBILITIES:

I understand that to ensure the confidentiality, integrity, availability, and security of Navy Information Technology (IT) resources and information, when using those resources, I shall:

-Safeguard information and information systems from unauthorized or inadvertent modification, disclosure, destruction, or misuse.

-Protect Controlled Unclassified Information (CUI), to include Personally Identifiable Information (PII), and classified information to prevent unauthorized access, compromise, tampering, or exploitation of the information.

-Protect authenticators (e.g., Password and Personal Identification Numbers (PIN)) required for logon authentication at the same classification as the highest classification of the information accessed.

-Protect authentication tokens (e.g., Common Access Card (CAC), Alternate Logon Token (ALT), Personal Identity Verification (PIV), National Security Systems (NSS) tokens, etc.) at all times. Authentication tokens shall not be left unattended at any time unless properly secured.

-Virus-check all information, programs, and other files prior to uploading onto any Navy IT resource.

-Report all security incidents including PII breaches immediately in accordance with applicable procedures.

-Access only that data, control information, software, hardware, and firmware for which I am authorized access by the cognizant Department of the Navy (DON) Commanding Officer, and have a need-to-know, have the appropriate security clearance. Assume only those roles and privileges for which I am authorized.

-Observe all policies and procedures governing the secure operation and authorized use of a Navy information system.

-Digitally sign and encrypt e-mail in accordance with current policies.

-Employ sound operations security measures in accordance with DOD, DON, service and command directives.

OPNAV 5239/14 (Rev 9/2011)

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REPLACES (Rev 7/2008), WHICH IS OBSOLETE FOR OFFICIAL USE ONLY WHEN FILLED

 

FOR OFFICIAL USE ONLY WHEN FILLED

(Block 22 Cont)

I further understand that, when using Navy IT resources, I shall not:

-Auto-forward any e-mail from a Navy account to commercial e-mail account (e.g, .com).

-Bypass, stress, or test IA or Computer Network Defense (CND) mechanisms (e.g., Firewalls, Content Filters, Proxy Servers, Anti-Virus Programs).

-Introduce or use unauthorized software, firmware, or hardware on any Navy IT resource.

-Relocate or change equipment or the network connectivity of equipment without authorization from the Local IA Authority (i.e., person responsible for the overall implementation of IA at the command level).

-Use personally owned hardware, software, shareware, or public domain software without written authorization from the Local IA Authority.

-Upload/download executable files (e.g., exe, .com, .vbs, or .bat) onto Navy IT resources without the written approval of the Local IA Authority.

-Participate in or contribute to any activity resulting in a disruption or denial of service.

-Write, code, compile, store, transmit, transfer, or Introduce malicious software, programs, or code.

-Use Navy IT resources in a way that would reflect adversely on the Navy. Such uses include pornography, chain letters, unofficial advertising, soliciting or selling except on authorized bulletin boards established for such use, violation of statute or regulation, inappropriately handled classified information and PII, and other uses that are incompatible with public service.

-Place data onto Navy IT resources possessing insufficient security controls to protect that data at the required classification (e.g., Secret onto Unclassified).

23.NAME (Last, First, Middle Initial):

24. USER SIGNATURE:

25. DATE SIGNED (DDMMMYYYY):

PART III - SECURITY MANAGER VALIDATES THE BACKGROUND INVESTIGATION OR CLEARANCE INFORMATION

26. TYPE OF INVESTIGATION:

 

 

26a. DATE OF INVESTIGATION (DDMMMYYYY):

 

 

 

 

 

 

 

 

 

 

26b. CLEARANCE LEVEL:

 

 

26c. IT LEVEL DESIGNATION

 

 

 

 

 

 

 

 

LEVEL I

 

LEVEL II

 

 

LEVEL III

 

 

 

 

 

 

 

 

 

 

 

 

 

 

27. VERIFIED BY (Print name):

28. SECURITY MANAGER

29. SECURITY MANAGER SIGNATURE:

 

 

30. DATE (DDMMMYYYY):

 

TELEPHONE NUMBER:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PART IV - COMPLETION BY AUTHORIZED STAFF PREPARING ACCOUNT INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

31. TITLE:

31a. SYSTEM:

 

 

 

 

31b. ACCOUNT CODE:

 

 

 

 

 

 

 

 

 

 

 

31c. DOMAIN:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

31d. SERVER:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

31e. APPLICATION:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

31f.

DATASETS:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

31g. DIRECTORIES:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

31h.

FILES:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

32. DATE PROCESSED (DDMMMYYYY): 32a.

PROCESSED BY:

 

 

 

 

32b. DATE (DDMMMYYYY):

33. DATE REVALIDATED (DDMMMYYYY):

33a. REVALIDATED BY:

33b. DATE (DDMMMYYYY):

OPNAV 5239/14 (Rev 9/2011)

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REPLACES (Rev 7/2008), WHICH IS OBSOLETE FOR OFFICIAL USE ONLY WHEN FILLED

 

FOR OFFICIAL USE ONLY WHEN FILLED

INSTRUCTIONS

A. PART I: The following information is provided by the user when establishing or modifying their USER IDENTIFICATION (ID).

(1)Name. The last name, first name, and middle initial of the user.

(2)Organization. The user's current organization (i.e., USS xx, DoD,and government agency or commercial firm).

(3)Office Symbol/Department. The office symbol within the current organization (i.e., SDI).

(4)Telephone Number/DSN. The Defense Switching Network (DSN) and commercial 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 (i.e., Systems Analyst YA-02, military rank (CAPT, United States Navy) or "CONT" if user is a contractor.

(7)Official Mailing Address. The user's official mailing address.

(8)Citizenship (United States (US), Foreign National (FN), Local National (LN), or Other), Identify appropriate citizenship in accordance with (IAW) SECNAV M-5510.30.

(9)Designation of Person (Military, Civilian, Contractor).

(10)IA Training and Awareness Certification Requirements. User must indicate if he/she has completed the Annual Information Awareness Training and the date of completion.

B. PART II: The information below requires the endorsement from the user's Supervisor or the Government Sponsor.

(11)Justification for Access. A brief statement is required to justify establishment of an initial USER ID. Provide appropriate information if the USER ID or access to the current USER ID is modified.

(12)Type of Access Required: Place an "X" in the appropriate box.

(Authorized - Individual with normal access. Privileged - Those with privilege to amend or change system configuration, parameters or settings.)

(12a) If Block 12 is Privileged, user must sign a Privilege Access Agreement form. Enter date of when Privilege Access Agreement (PAA) form was signed. Users can obtain a PAA form from the Information Assurance Manager (IAM) or Appointee.

(13)User Requires Access To. Place an "X" in the appropriate box. Specify category.

(14)Verification of Need to Know. To verify that the user requires access as requested.

(14a) Expiration Date for Access. The user must specify expiration date if less than 1 year.

(15)Supervisor's Organization/Department. Supervisor's organization and department.

(15a) Official E-mail Address. Supervisor's e-mail address.

(15b) Phone Number. Supervisor's telephone number.

(16)Supervisor's Name (Print Name). The supervisor or representative prints his/her name to indicate that the above information has been

verified and that access is required.

(16a) Supervisor's Signature. Supervisor's signature is required by the endorser or his/her representative.

(16b) Date. Date supervisor signs the form.

(17)Signature of Information Owner/OPR. Signature of the functional appointee responsible for approving access to the system being

requested.

(17a) Phone Number. Functional appointee telephone number.

(17b) Date. The date the functional appointee signs the OPNAV 5239/14.

(18)Signature of Information Assurance Manager (IAM) or Appointee. Signature of the IAM or Appointee of the office responsible for approving access to the system being requested.

(19)Organization/Department. IAM's organization and department.

(20)Phone Number. IAM's telephone number.

(21)Date. The date the IAM signs the OPNAV 5239/14 form.

(22)Standard Mandatory Notice and Consent Provision and User Responsibilities. These items are in accordance with DoD Memo dtd May 9, 2008 (Policy on Use of DoD Information Systems - Standard Consent Banner and User Agreement) and DON CIO message Responsible and Effective Use of Dept of Navy Information Technology Resources" DTG 161108Z JUL 05.

(23)Name. The last name, first name, and middle initial of the user.

(24)User Signature. User must sign the OPNAV 5239/14 with the understanding that they are responsible and accountable for their password and access to the system(s). User shall digitally sign form. Pen and ink signature is acceptable for users that do not have a Common Access Card (CAC) or the ability to digitally sign the form.

(25)Date. Date signed.

C.PART III: Certification of Background Investigation or Clearance.

(26)Type of Investigation. The user's last type of background investigation (i.e., National Agency Check (NAC), National Agency Check with Inquiries (NACI), or Single Scope Background Investigation (SSBI)).

(26a) Date of Investigation. Date of last investigation.

(26b) Clearance Level. The user's current security clearance level (Secret or Top Secret).

(26c) Identify the user's IT designation level. If Block 12 is designated as "Authorized" then IT Level Designation is "Level III". If Block 12 is designated as "Privileged" then IT Level Designation is "Level I or II" based on SECNAV M-5510.30 dtd June 2006.

(27)Verified By. The Security Manager or representative prints his/her name to indicate that the above clearance and investigation information has been verified.

(28)Security Manager Telephone Number. The telephone number of the Security Manager or his/her representative.

(29)Security Manager Signature. The Security Manager or his/her representative indicates that the above clearance and investigation information has been verified.

(30)Date. The date that the form was signed by the Security Manager or his/her representative.

D.PART IV: This information is site specific and can be customized by either the functional activity or the customer with approval from OPNAV. This information will specifically identify the access required by the user.

(31 - 33b). Fill in appropriate information.

E. DISPOSITION OF FORM:

TRANSMISSION: Form may be electronically transmitted, faxed or mailed. If the completed form is transmitted electronically, the e-mail must be digitally signed and encrypted.

FILING: Form is purposed to use digital signatures. Digitally signed forms must be stored electronically to retain non-repudiation of electronic signature. If pen and ink signature must be applied, original signed form must be retained. Retention of this form shall be IAW SECNAV Manual M-5210.1, Records Management Manual. Form may be maintained by the Navy, the user's IAM, and/or Security Manager. Completed forms contain Personal Identifiable Information (PII) and must be protected as such.

OPNAV 5239/14 (Rev 9/2011)

Page 4 of 4

REPLACES (Rev 7/2008), WHICH IS OBSOLETE FOR OFFICIAL USE ONLY WHEN FILLED

 
Get 5239 14 PDF Form

Form Characteristics

Fact Name Details
Governing Authority The form is authorized under Executive Order 10450, Public Law 99-474, and the Computer Fraud and Abuse Act.
Principal Purpose It serves to record user identification for verifying individual access requests to Department of Defense systems.
Routine Uses Data collected is available to Navy Personnel Supervisors, Security Managers, and System Administrators with a need to know.
Disclosure Statement Providing information is voluntary but necessary; failure to give it may delay processing.
Access Types The form allows requests for initial, modification, or deactivation of user IDs across various DOD systems.
User Compliance Users must safeguard information and adhere to all relevant policies regarding the use of Navy IT resources.

Guidelines on Utilizing 5239 14

Completing the OPNAV 5239/14 form is an important step for individuals seeking access to Department of Defense systems. It involves providing specific information about oneself and obtaining necessary endorsements from supervisors and information security personnel. Once the form is filled out correctly, it will be processed according to departmental procedures.

  1. Part I: User Information
    • Fill in your last name, first name, and middle initial.
    • Indicate the organization you currently belong to.
    • Provide the office symbol or department associated with your organization.
    • List your phone number, including DSN and commercial numbers.
    • Enter your official e-mail address.
    • State your job title and grade or rank.
    • Provide your official mailing address.
    • Specify your citizenship status (U.S., Foreign National, Local National, or Other).
    • Select your designation (Civilian, Military, Contractor, etc.).
    • Confirm if you have completed the Annual Information Assurance Training and provide the completion date.
  2. Part II: Supervisor Endorsement
    • Provide a brief justification for why you need access.
    • Select the type of access required (Authorized or Privileged).
    • If selected Privileged, sign and date the Privileged Access Agreement Form.
    • Choose whether you require access to Unclassified or Classified information and specify the category if classified.
    • Verify that you require access as requested and provide any expiration dates if necessary.
    • List your supervisor's organization and department along with their official e-mail address and phone number.
    • Print your supervisor’s name, and have them sign and date the form.
    • Have the information owner sign and provide their phone number and date.
    • Obtain the signature of the Information Assurance Manager or Appointee.
    • Provide their organization, phone number, and date of signing.
  3. Part III: Security Manager Verification
    • Document the type of background investigation and its date.
    • Indicate your current clearance level.
    • Identify the IT level designation as required.
    • Have the Security Manager print and sign their name, and include the date and phone number.
  4. Part IV: Final Details
    • Complete site-specific information such as title, system, and account code.
    • Document the date processed and who processed it.
    • Complete any necessary revalidation information.
  5. Final Steps
    • Ensure the form is signed. Use a digital signature where possible, or a pen and ink signature if necessary.
    • Submit the completed form following departmental transmission guidelines, whether electronically or through fax/mail.
    • Keep a secure copy of the completed form since it contains personal information.

After completing the form, it will go through a processing phase where the requester’s access will be evaluated and approved based on the provided information and endorsements. Adhering closely to these instructions helps to ensure efficient processing and compliance with Department of Defense policies.

What You Should Know About This Form

What is the purpose of the OPNAV 5239/14 form?

The OPNAV 5239/14 form is used to record user identification. It is essential for verifying the identities of individuals who request access to Department of Defense (DOD) systems and information. This form ensures that only authorized personnel can access sensitive information, enhancing security within the Navy.

Who needs to fill out the OPNAV 5239/14 form?

Any individual seeking to obtain, modify, or deactivate a user ID for accessing Navy IT resources must complete the OPNAV 5239/14 form. This includes military personnel, civilians, and contractors who have a need for access to DOD systems.

What information is required in the first part of the form?

The first part of the form, to be completed by the requester, requires personal details such as name, organization, job title, contact information, citizenship status, and certification of completed Annual Information Assurance Training. All information provided must be accurate to prevent delays in processing the request.

What is meant by “justification for access”?

In the context of the form, the “justification for access” refers to a brief explanation provided by the user's supervisor or sponsor that supports the user's need for access. This must clarify why the particular access is necessary for the user’s role or responsibilities.

What are the consequences of not providing requested information?

While disclosure of information on the OPNAV 5239/14 is voluntary, failure to provide complete information may lead to impediments or delays in the processing of the access request. Therefore, it's crucial for applicants to supply all required information accurately.

What is the significance of the Privileged Access Agreement?

If a user indicates their access type as “Privileged,” they must sign a Privileged Access Agreement form. This agreement outlines responsibilities regarding the elevated access permissions and ensures that users understand the implications and obligations associated with privileged access.

How is the form processed once filled out?

Once completed, the form will undergo a validation process by the relevant security manager who will verify the applicant’s background investigation or security clearance. Afterward, the authorized staff will finalize account information based on the provided data.

Is electronic transmission of the OPNAV 5239/14 form allowed?

Yes, the OPNAV 5239/14 form can be transmitted electronically, faxed, or mailed. If sent electronically, the email must be digitally signed and encrypted to maintain security and integrity of the submitted information.

How is personal information protected in this form?

The OPNAV 5239/14 form contains personally identifiable information (PII) and must be handled with care. It is essential to protect this information in accordance with established privacy regulations, and the retention of these forms should follow the guidelines set forth in the SECNAV Manual M-5210.1.

Common mistakes

Completing the OPNAV 5239/14 form can be challenging, and many individuals make mistakes that can delay their access requests. A common error is not providing the correct full name. The form requires the last name, first name, and middle initial. If any part of this is missing or misspelled, it can lead to significant processing delays.

Another common mistake involves inaccurate contact information. Users must include a phone number, both DSN and commercial, along with an official email address. Omitting any of these details can halt the request process. Remember, the Navy’s personnel require accurate information to reach user contacts easily.

Many people also overlook the justification for access. This part is crucial as it explains why access is needed. A vague or missing justification can lead to rejection of the request. It is important to provide a clear rationale for the access being sought.

Additionally, users sometimes forget to sign the form. This final step is essential. Without a signature, the document cannot be processed. Similarly, failing to date the signature can result in further complications.

Another frequent error occurs in regard to citizenship designation. Users must accurately identify whether they are a U.S. citizen, foreign national, local national, or another designation. Incorrect citizenship information can lead to immediate disqualification from accessing certain systems.

Part II of the form requires endorsement from the user's supervisor. Some individuals skip this step or neglect to ensure that their supervisor has completed the required sections. If this endorsement is not present, the submission will be rejected.

One essential aspect that cannot be ignored is the Information Assurance (IA) training certification. Users must indicate if they have completed this training. Failing to denote this can hinder the approval process.

Lastly, it is crucial to verify the required access level. If the form indicates that access is needed to both classified and unclassified data, the user must specify the categories clearly. Misunderstanding or misrepresenting access requirements can result in the form being returned for revision.

Documents used along the form

When it comes to processing requests for access to Department of Defense systems, it’s essential to use a comprehensive set of forms to ensure security and compliance. The OPNAV 5239/14 form is just one piece of the puzzle. Below is a list of other important documents that often accompany this form, each serving a unique purpose.

  • SF 85 - Questionnaire for Non-Sensitive Positions: This form gathers information needed for background investigations for non-sensitive positions, ensuring those granted access have been properly vetted.
  • SF 86 - Questionnaire for National Security Positions: Used for individuals requiring access to classified information, this document collects detailed personal information for a comprehensive security clearance process.
  • SF 312 - Classified Information Nondisclosure Agreement: This agreement certifies that individuals understand the responsibilities and consequences of accessing classified information.
  • DoD Form 2875 - System Authorization Access Request (SAAR): This is used for requesting access to various Department of Defense systems and is critical for documenting users’ access rights.
  • IA Awareness Training Certification: A document proving that individuals have completed required Information Assurance training, highlighting the importance of safeguarding sensitive data.
  • Privileged Access Agreement Form: Required for users needing privileged access, this agreement outlines the responsibilities that come with elevated access levels.
  • Network Access Request (NAR): This form is aimed at managing requests for access to network resources, helping to verify user credentials and the necessity of access.
  • Personnel Security Clearance Request: Used to initiate the clearance process, this form collects basic information to begin background checks for individuals needing access to sensitive information.
  • Incident Report Form: A form used to document any security incidents or breaches, which is crucial for maintaining the integrity of information systems and for learning from mistakes.
  • Access Termination Form: This form is used when access needs to be revoked, ensuring proper documentation and compliance with security protocols.

These forms and documents play a pivotal role in maintaining security within the Department of Defense. Familiarity with each can greatly enhance the compliance process, ensuring that all users are adequately vetted and understand their responsibilities while accessing sensitive systems.

Similar forms

  • Standard Form 86 (SF-86): This document is similar in that it is used to collect personal information for security clearance applications. Like the 5239 14 form, it aims to verify identities and assess access requirements for sensitive information.
  • Department of Defense Form 2875: This form serves as a system authorization request and is utilized to grant individuals access to various DoD systems. It involves a user verification process, paralleling the functionality of the 5239 14 form in ensuring proper clearance and authorized use.
  • Office of Personnel Management Form 1203-FX: This form allows individuals to apply for federal jobs and collect pertinent personal information. Similar to the 5239 14, it includes sections for verifying identity and background information necessary for security reasons.
  • Form I-9: Used for verifying employment eligibility, this form collects personal details and requires identification verification. This aligns with the 5239 14 form’s goal of establishing identity within a secure environment.
  • Federal Information Security Modernization Act (FISMA) Compliance Documentation: This includes various forms and assessments aimed at ensuring information security within federal agencies, resembling the safeguarding measures outlined in the 5239 14 in terms of data protection and user accountability.

Dos and Don'ts

  • Do: Ensure all personal information is accurate, including your name, organization, and citizenship.
  • Do: Complete the training certification section, indicating if you have completed the required Information Assurance Awareness Training.
  • Do: Provide clear justification for access in Part II of the form. This helps in processing your request efficiently.
  • Do: Check all entries for clarity and completeness before submitting to avoid delays.
  • Don't: Autocomplete fields based on assumptions; each field must be filled out based on your current status.
  • Don't: Ignore deadlines for submitting your request or the expiration dates required for contractor access.
  • Don't: Leave sections blank unless explicitly instructed; incomplete forms can be rejected or delayed.

Misconceptions

  • Misconception: The 5239 14 form is only for military personnel. This form is applicable to various users, including civilians and contractors, who need access to Department of Defense systems.
  • Misconception: Completing the form guarantees access to systems. Submission of the form does not automatically grant access; it merely initiates the request process that requires verification and approval.
  • Misconception: User training is optional. Completing Information Assurance (IA) Awareness Training is mandatory to ensure users understand security protocols.
  • Misconception: The information on the form is private. While personal details are required, users should know that this information can be monitored and reviewed by authorized personnel.
  • Misconception: Only one signature is necessary. Multiple signatures are required, including that of the user, the supervisor, and the Information Assurance Manager.
  • Misconception: The form never expires. Any access granted via the form has an expiration specified, which must be tracked and renewed as necessary.
  • Misconception: A digital signature is the only acceptable form of signing. While digital signatures are preferred, pen and ink signatures are acceptable for users without Common Access Cards.
  • Misconception: The 5239 14 form is not related to security clearance. The form includes sections to verify and document background investigations and security clearance status.
  • Misconception: There are no consequences for failing to comply with form requirements. Non-compliance can result in the denial of access or disciplinary actions for the user and their supervisor.
  • Misconception: The form is filled out only once. Users must complete the form any time they modify their access, change roles, or need to renew access.

Key takeaways

  • Completion Requirements: Ensure all sections of the OPNAV 5239/14 form are thoroughly filled out. Missing information can delay processing.
  • Access Justification: A clear justification for access is needed. Briefly explain why access is necessary in Part II.
  • Training Confirmation: Confirm completion of Annual Information Assurance Awareness Training. This is mandatory for user access.
  • Signature Authority: Supervisors must endorse the request, certifying that the user meets the necessary requirements for access. Their signature is crucial.
  • Data Protection: Safeguard PII and classified information. Follow all security protocols to prevent unauthorized access or data breaches.

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