BPA F 5632.30e Pin Code Request

BPA F 5632.30e
(09-19)

U.S. DEPARTMENT OF ENERGY BONNEVILLE POWER ADMINISTRATION (BPA)

OMB Control Number: 1910-5188
Expiration Date: 08/31/2022

PIN CODE REQUEST
INSTRUCTIONS: Some physical access control systems (PACS) require the use of a 4-digit PIN code for access to specifically
identified areas within BPA. These areas include, but are not limited to: the Dittmer building, Dittmer Control Center, NERC CIP field
sites, and other sensitive areas. BPA employees who have access permissions for these areas, or who would like general access to
the Dittmer building, need to establish a single PIN which will be associated with each access card held by the employee.
This form is to be used only by employees who do not have BPA network access, or who have a limited ability for accessing the
network due to their position/duties. This form is to be completed, emailed to: Employee Badging at [email protected] or printed
and mailed in a sealed blue envelope to: Employee Badging – NNP-B1.
Employees who have routine network access need to complete the PIN selection process through the agency’s automated PIN web
application at https://accesscardpin.bud.bpa.gov/.

A. PIN RETRIEVAL
If an employee forgets their PIN, they can contact the offices listed below to retrieve it. When asked, the employee will provide the
answer to their security question they provide below (Item 6) to validate their identity.
•
Alarm Monitoring Station (primary) - 360-418-2470
•
The Dittmer Control Center Security Privilege Coordinator (alternate) - 360-418-2111

B. PIN SELECTION
1. Last Name:

2. First Name:

3. Middle Initial/NMI:

4. Choose a PIN number for your access card. Select 4 digits (example – 1130).
•
Do not choose numbers that are confidential or Personally Identifiable Information (PII) such as the last four digits of your
social security number.
•
Numbers that are unacceptable include four repeating numbers (e.g. – 5555) or sequential numbers (e.g. – 1234, 9876).

Write in your selected PIN below:

5. Select one of the three security questions identified below as your security question:
What was the model of your first car?
What was your first pet’s name?
What is your favorite movie or book?
6. Provide your answer to the security question selected above:

Please provide the name of your Supervisor/COTR who will receive confirmation when your PIN has been established and will notify
you.
7. Last Name:
8. First Name:
9. Middle Initial/NMI:

File Code; ES-15-01 Retention; See Agency File Plan

OFFICIAL USE ONLY
May be exempt from public release under the Freedom of
Information Act (5 USC 552),
exemption number and category: ______________.
BPA review required before public release.
Name/Org: ___________________________ Date:___________

OFFICIAL USE ONLY

BPA F 5632.30e
(09-19)

U.S. DEPARTMENT OF ENERGY BONNEVILLE POWER ADMINISTRATION (BPA)

OMB Control Number: 1910-5188
Expiration Date: 08/31/2022

PIN CODE REQUEST

Paperwork Reduction Act Burden Disclosure Statement
This data is being collected to ensure the security and safety of BPA employees, contractors, and facilities. The data you supply will be used by
employees/contractors to set a pin code associated with a local site specific only badge or proximity card. Public reporting burden for this
collection of information is estimated to average .083 hours per response, including the time for reviewing instructions, searching exiting
data sources, gathering and maintaining that 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 this burden, to Office
of the Chief Information Officer, Enterprise Policy Development & Implementation Office, IM-22, Paperwork Reduction Project (OMB control
number 1910-5188), U.S. Department of Energy, 1000 Independence Ave SW, Washington, DC, 20585-1290; and to the Office of Management and
Budget (OMB), OIRA, Paperwork Reduction Project (OMB control number 1910-5188), Washington, DC 20503.
Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject to a penalty for failure
to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information
displays a currently valid OMB control number.
The Paperwork Reduction Act (PRA) of 1995 requires each Federal agency to seek and obtain approval from the Office of Management and Budget
(OMB) before undertaking a collection of information directed to 10 or more persons of the general public, including persons involved in or
supporting the operations of Government-owned, contractor-operated facilities.
Submission of this data is required.