Permit to Report Checklist

PERMIT TO REPORT CHECKLIST (PAGE 1 OF 2)
COMPLETED

DOCUMENT

DUE DATE

RETURN ADDRESS

NOTES

Academic Background System
(ABS) Questionnaire for the
Class of 2025 & Validation Tests

Receipt of
Package + 2
Weeks

N/A

Complete Questionnaire within two weeks of receiving Permit to
Report (PTR) package. All questionnaires must be completed by
I-Day. Additionally, complete all additional placement tests that
are listed.

NHCA

Changes in Health Status

As Needed

Email: [email protected]

E-mail or fax any changes in health since DoDMERB examination
as stated under Section IV of Information Booklet.

NAF

Uniform Measurements

21-May-20

See “Important Information for
the Class of 2025”

Measurements must be entered online

Personal Swearing-In
Ceremony Form

21-May-20

“[email protected]”

Complete and Email to noted address

[email protected]

Complete online application process. If you do not wish to use
NFCU, bring a copy of direct deposit slip from desired bank on
I-Day.

OMB

OMB
NFCU

Midshipmen Pay and
NFCU application

21-May-20

NHCA

Immunization Record and COVID Form
Questionaire
(DD3111 and DHA Form 207)

21-May-20

NHCA

Patient Registration Form
(NHCLA 6150/24)

21-May-20

NHCA

USNA Appointee Spectacle
Prescription Information Form

21-May-20

Mantoux Tuberculin
Skin Test (PPD) Form

21-May-20

OMB

Proof of Citizenship and
Police Record Check

21-May-20

OMB

Statement of understanding
regarding body alterations

21-May-20

Base Access Card Application (SECNAV
5512)

21-May-20

Alumni Association and
Foundation Forms, Plebe/Parent
Information Form, Parent
Association Membership Form

9-Jun-20

[email protected]

Complete online questionnaire. Permission to Share can be
returned to the email address provided or brought on I-Day.

OMB

Plebe Sponsor Questionnaire

25-Jun-20

N/A

Candidates must complete questionnaire and return via email to
[email protected]. Candidates can complete on I-Day, if required.

Diff SORN

Request and Authorization for
Midshipmen Accession Travel
(USNA 4600/8)

I-Day

[email protected]

Scan document to a PDF file and email directly

Agreement to Serve Forms

I-Day

N/A

Sign, date and bring two copies bring with you on I-Day. Retain
one copy for your records. If under 18, parent/guardian signature
is required.

I-Day

N/A

Bring with you on I-Day

I-Day

N/A

Bring with you on I-Day

NHCA

SECNAV
NFE

OMB
SGLV
NAVPERS

Service Member's Group Life
Insurance (SGLI) Form
Record of Emergency Data
(NAVPERS 1070/602)

Medical Records
Naval Health Clinic
695 Kinkaid Road
Annapolis, MD 21402-5050
Medical Records
Naval Health Clinic
695 Kinkaid Road
Annapolis, MD 21402-5050
Naval Health Clinic Annapolis
250 Wood Road
Annapolis, MD 21402-5050
Medical Records
Naval Health Clinic
695 Kinkaid Road
Annapolis, MD 21402-5050
U.S. Naval Academy
Office of Admissions
Attn: Nominations and
Appointments
52 King George Street
Annapolis, MD 21402-1318
U.S. Naval Academy
Office of Admissions
Attn: Nominations and
Appointments
52 King George Street
Annapolis, MD 21402-1318
Pass and ID Office/Security
USNA
BLDG 351/Visitors Access
Center
Annapolis, MD 21401

Complete Part I; licensed health care provider complete Part II.
Make a copy. Return original to address listed (Envelope not
provided) and BRING copy with you on I-Day.
Complete and return original to address listed. Envelope not
provided. Bring copy on I-Day.
Complete and return original to address listed or fax to
(410)-293-1131 (do not use a cover sheet or fax any other forms).
Envelope not provided. Bring copy on I-Day.
Documented PPD test provided by your doctor's office must be
completed within six months of I-Day. Return proof of current
PPD test results to address listed. Envelope not provided.

If you haven’t already done so, return documents to Admissions.
(Information requested with Offer of Appointment. Not a part of
PTR Package.)

If you haven’t already done so, return statement of understanding
to Admissions. (Information requested with Offer of Appointment.
Not a part of PTR Package.)

Complete and mail to security office

Please return all forms as indicated above and in the Important Information booklet.
Use a BLACK pen. Do not return any personal letters; they are yours to keep

PERMIT TO REPORT CHECKLIST (PAGE 2 OF 2)
COMPLETED

SF

DOCUMENT
Standard Form (SF)-86
Questionnaire

DUE DATE

RETURN ADDRESS

NOTES

I-Day

N/A

Bring with you on I-Day

OMB

Notice Regarding Maintenance
of Private Medical Insurance

I-Day

N/A

Bring with you on I-Day

OMB

Permit to Report Letter

I-Day

N/A

Bring with you on I-Day

NA

Flight Itinerary, Copy of Ticket, All
Travel Receipts

I-Day

N/A

Bring a copy of airline or rail ticket/itinerary showing dollar
amount that you paid along with any travel receipts.

NA

Note from Physician for
prescribed medication

I-Day

N/A

See note under Section IV.

Social Security Card

I-Day

N/A

Bring Social Security Card on I-Day. If you do not have a Social
Security Card, then you must obtain one. If you are receiving
Social Security benefits, notify appropriate office of entrance to
USNA.

NA
NA
NHCLANNA

NA

Orthodontic Waiver Letter

I-Day

N/A

IF REQUIRED – Bring waiver, copy of your initial treatment plan
and all orthodontic records with you on I-Day. If you do not have
a waiver from the application process, then your braces must be
removed.

Medical Record
Supplemental Medical Data
(NHCLANNA 6150/2)

I-Day

N/A

Complete and bring with you on I-Day.

ACE Loan/Scholarship
Information

As
Applicable

Midshipmen Disbursing Office
U.S. Naval Academy
101 Buchanan Road, Room 4002
Annapolis, MD 21402

As Applicable – Scholarship checks and letters should be mailed
to the Midshipmen Disbursing Office no earlier than the start of
the Academic Year.

Please return all forms as indicated above and in the Important Information booklet.
Use a BLACK pen. Do not return any personal letters; they are yours to keep