Form SF315 TSP Request for Service Users

TELECOMMUNICATIONS SERVICE PRIORITY (TSP) SYSTEM
TSP REQUEST FOR SERVICE USERS

Form Approved
OMB No. 1630-0002
Expires July 31, 2007

(See NCS Manual 3-1-1 for instructions before completion.)

The public reporting burden for this collection of information is estimated to average 1 hour and 15 minutes per response, including the time for reviewing instructions, searching existing
data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of
this collection of information, including suggestions for reducing the burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and
Reports (1630-0002), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person
shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THIS ADDRESS. RETURN COMPLETED FORM TO ADDRESS BELOW.
1. ACTION REQUESTED (Enter applicable code) (If "C" or "D", complete Items 4, 9, 10, 11, and 12 at a minimum.)
A ASSIGN INITIAL PRIORITY FOR A SERVICE
C CHANGE TO A SERVICE, SERVICE PRIORITY, OR INFORMATION ABOUT A SERVICE
D DELETE/REVOKE A SERVICE'S PRIORITY
2. DATE SERVICE REQUIRED (MMDDYYYY)

3. SERVICE USER SERVICE ID

4. TSP AUTHORIZATION CODE (Complete below only if Action Requested in Item 1 is C or D.)

T

S

P

5. SERVICE PROFILE (List all profile elements that describe the user's level of support for the service.)

6. RESTORATION PRIORITY INFORMATION (Complete ONLY if requesting a restoration priority)
a. CATEGORY UNDER WHICH SERVICE QUALIFIES FOR PRIORITY TREATMENT (A, B, C or D)
b. CATEGORY CRITERIA UNDER WHICH SERVICE QUALIFIES
c. RESTORATION PRIORITY REQUESTED (5, 4, 3, 2, or 1)
d. PRIME VENDOR (Company Name)
7. PROVISIONING PRIORITY INFORMATION (Complete ONLY if requesting a provisioning priority)
a. CATEGORY UNDER WHICH SERVICE QUALIFIES FOR PRIORITY TREATMENT (A, B, C , D, or E)
b. CATEGORY CRITERIA UNDER WHICH SERVICE QUALIFIES
c. PROVISIONING PRIORITY REQUESTED (5, 4, 3, 2, 1, or E)
d. INVOCATION OFFICIAL'S NAME

e. INVOCATION OFFICIAL'S TITLE

f. TELEPHONE NUMBER (Area Code/Number/Extension)

g. HAS THE INVOCATION OFFICIAL AUTHORIZED
THIS ACTION? (Y or N)

h. SERVICE LOCATIONS (Street Address, Building Number, Room Number, etc.) AND 24-HOUR POINT OF CONTACT FOR EACH END
SERVICE LOCATION

i. PRIME VENDOR POINT-OF-CONTACT FOR PROVISIONING (Point of Contact Name, Telephone Number, and Company)

AUTHORIZED FOR LOCAL REPRODUCTION

STANDARD FORM 315 (Revised 3/06)

Prescribed by DHS/NCS
NCS Manual 3-1-1

8. SUPPLEMENTAL INFORMATION (Provide: (1) circuit specification(s) for provisioning priority only; (2) justification for requested priority
level if higher than qualified for; or (3) justification for disapproval or priority level change in sponsorship disposition field (12e).)

9. SERVICE USER (Enter applicable code)
A FEDERAL GOVERNMENT
C LOCAL GOVERNMENT
B STATE GOVERNMENT
D PRIVATE SECTOR
10. SERVICE USER ORGANIZATION (Dept/Agency and FIPS Code)

E FOREIGN GOVERNMENT
F OTHER

G U.S. MILITARY

11. SERVICE USER POINT-OF-CONTACT (For correspondence regarding this service)
a. NAME AND TITLE
b. ORGANIZATION (Dept/Agency and FIPS Code)

c. (1) MAILING ADDRESS

(2) CITY

(3) STATE

(4) ZIP CODE

d. TELEPHONE NUMBER (Area Code/Number/Extension)

e. FACSIMILE NUMBER (Area Code/Number/Extension)

f. 24-HOUR TELEPHONE NUMBER (Area Code/Number/Extension)

g. ELECTRONIC MAILING ADDRESS

h. SIGNATURE AND DATE: I confirm this is National Security and Emergency Preparedness (NS/EP) service.

12. SPONSORSHIP INFORMATION FOR NON-FEDERAL SERVICE (To be completed by sponsor)
a. FEDERAL SPONSORING AGENCY AND FIPS CODE
b. SPONSOR NAME

d. TELEPHONE NUMBER (Area Code/Number/Extension)

c. SPONSOR TITLE

e. RECOMMENDED DISPOSITION (X one)
APPROVE

DISAPPROVE

APPROVE WITH PRIORITY LEVEL CHANGE

f. SPONSOR SIGNATURE AND DATE: I confirm this is National Security and Emergency Preparedness (NS/EP) service.

Non-Federal users: send form to your Federal Government sponsor.
Federal users or sponsors: send completed form to:

Manager, National Communications System
Attention: Office of Priority Telecommunications
701 South Court House Road
Arlington, VA 22204-2198
STANDARD FORM 315 (BACK) (Revised 3/06)