VA Authorization to Transport Information
4. The timeframe I will store, transport and utilize VA sensitive information outside protected environments is: 30 days 180 days One Year (Maximum – must be reviewed annually) Other: ______________ 5. I acknowledge that the above statements are accurate and are in compliance with VA Directive and Handbook 6500, Managing Information Security Risk: VA Information Security Program. 6. I acknowledge this document requires renewal upon expiration of the approval timeframe requested above. ________________________ Requestor’s Signature
_____________ Date
================================================================== Required Concurrence and Approval _______________________________ Supervisor’s Name Concur / Do Not Concur
_______________________________ Supervisor’s Signature
_____________ Date
Concur / Do Not Concur
_______________________________ Service Chief
_____________ Date
Concur / Do Not Concur
________________________________ (ITS) ( ) Facility Information Security Officer
_____________ Date
Concur / Do Not Concur
________________________________ ( ) Facility Chief Information Officer
_____________ Date
Approved / Disapproved
________________________________ ( ) Director
_____________ Date
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