Exploration AND SPACE Communications PROJECTS Division (ESC)

**NEXT GENERATION INTEGRATED NETWORK (NGIN)** ACCOUNT REQUEST DOCUMENT

+---------+-----+------+-----------+---+----------+---+-------+-----------+
| 1\.     |     |      | First     |   |          | M |       |           |
| Last    |     |      | Name      |   |          | i |       |           |
| Name    |     |      |           |   |          | d |       |           |
|         |     |      |           |   |          | d |       |           |
|         |     |      |           |   |          | l |       |           |
|         |     |      |           |   |          | e |       |           |
|         |     |      |           |   |          | I |       |           |
|         |     |      |           |   |          | n |       |           |
|         |     |      |           |   |          | i |       |           |
|         |     |      |           |   |          | t |       |           |
|         |     |      |           |   |          | i |       |           |
|         |     |      |           |   |          | a |       |           |
|         |     |      |           |   |          | l |       |           |
+---------+-----+------+-----------+---+----------+---+-------+-----------+
|         |     |      |           |   |          |   |       |           |
+---------+-----+------+-----------+---+----------+---+-------+-----------+
| 2\.     |     |      |           |   |          | 3 |       |           |
| Mailing |     |      |           |   |          | \ |       |           |
| Address |     |      |           |   |          | . |       |           |
| at Work |     |      |           |   |          | E |       |           |
| **(     |     |      |           |   |          | m |       |           |
| include |     |      |           |   |          | a |       |           |
| Bl      |     |      |           |   |          | i |       |           |
| dg/Room |     |      |           |   |          | l |       |           |
| #)**    |     |      |           |   |          | A |       |           |
|         |     |      |           |   |          | d |       |           |
|         |     |      |           |   |          | d |       |           |
|         |     |      |           |   |          | r |       |           |
|         |     |      |           |   |          | e |       |           |
|         |     |      |           |   |          | s |       |           |
|         |     |      |           |   |          | s |       |           |
+---------+-----+------+-----------+---+----------+---+-------+-----------+
|         |     |      |           |   |          |   |       |           |
+---------+-----+------+-----------+---+----------+---+-------+-----------+
| 4\.     |     |      | Fax       |   |          | W |       |           |
| Contact |     |      | Number    |   |          | o |       |           |
| Info.:  |     |      |           |   |          | r |       |           |
| Te      |     |      |           |   |          | k |       |           |
| lephone |     |      |           |   |          | C |       |           |
| Number  |     |      |           |   |          | e |       |           |
|         |     |      |           |   |          | l |       |           |
|         |     |      |           |   |          | l |       |           |
|         |     |      |           |   |          | / |       |           |
|         |     |      |           |   |          | P |       |           |
|         |     |      |           |   |          | a |       |           |
|         |     |      |           |   |          | g |       |           |
|         |     |      |           |   |          | e |       |           |
|         |     |      |           |   |          | r |       |           |
|         |     |      |           |   |          | N |       |           |
|         |     |      |           |   |          | u |       |           |
|         |     |      |           |   |          | m |       |           |
|         |     |      |           |   |          | b |       |           |
|         |     |      |           |   |          | e |       |           |
|         |     |      |           |   |          | r |       |           |
+---------+-----+------+-----------+---+----------+---+-------+-----------+
|         |     |      |           |   |          |   |       |           |
+---------+-----+------+-----------+---+----------+---+-------+-----------+
| 5\.     |     |      |           |   |          | 6 |       |           |
| Affil   |     |      |           |   |          | \ |       |           |
| iation: |     |      |           |   |          | . |       |           |
| **(     |     |      |           |   |          | N |       |           |
| Provide |     |      |           |   |          | A |       |           |
| Organ   |     |      |           |   |          | S |       |           |
| ization |     |      |           |   |          | A |       |           |
| Code,   |     |      |           |   |          | C |       |           |
| Company |     |      |           |   |          | i |       |           |
| Name,   |     |      |           |   |          | v |       |           |
| Uni     |     |      |           |   |          | i |       |           |
| versity |     |      |           |   |          | l |       |           |
| Name,   |     |      |           |   |          | S |       |           |
| or      |     |      |           |   |          | e |       |           |
| other:\ |     |      |           |   |          | r |       |           |
| Also    |     |      |           |   |          | v |       |           |
| supply  |     |      |           |   |          | a |       |           |
| c       |     |      |           |   |          | n |       |           |
| ontract |     |      |           |   |          | t |       |           |
| and     |     |      |           |   |          | ? |       |           |
| task    |     |      |           |   |          |   |       |           |
| number, |     |      |           |   |          |   |       |           |
| if      |     |      |           |   |          |   |       |           |
| contra  |     |      |           |   |          |   |       |           |
| ctor)** |     |      |           |   |          |   |       |           |
+---------+-----+------+-----------+---+----------+---+-------+-----------+
|         |     |      |           |   |          |   |       | No        |
|         |     |      |           |   |          | Y |       |           |
|         |     |      |           |   |          | e |       |           |
|         |     |      |           |   |          | s |       |           |
+---------+-----+------+-----------+---+----------+---+-------+-----------+
| 7\.     |     |      |           | 8 |          |   |       |           |
| Fun     |     |      |           | \ |          |   |       |           |
| ctional |     |      |           | . |          |   |       |           |
| Title:  |     |      |           | C |          |   |       |           |
|         |     |      |           | i |          |   |       |           |
|         |     |      |           | t |          |   |       |           |
|         |     |      |           | i |          |   |       |           |
|         |     |      |           | z |          |   |       |           |
|         |     |      |           | e |          |   |       |           |
|         |     |      |           | n |          |   |       |           |
|         |     |      |           | s |          |   |       |           |
|         |     |      |           | h |          |   |       |           |
|         |     |      |           | i |          |   |       |           |
|         |     |      |           | p |          |   |       |           |
|         |     |      |           | o |          |   |       |           |
|         |     |      |           | f |          |   |       |           |
|         |     |      |           | t |          |   |       |           |
|         |     |      |           | h |          |   |       |           |
|         |     |      |           | e |          |   |       |           |
|         |     |      |           | R |          |   |       |           |
|         |     |      |           | e |          |   |       |           |
|         |     |      |           | q |          |   |       |           |
|         |     |      |           | u |          |   |       |           |
|         |     |      |           | e |          |   |       |           |
|         |     |      |           | s |          |   |       |           |
|         |     |      |           | t |          |   |       |           |
|         |     |      |           | o |          |   |       |           |
|         |     |      |           | r |          |   |       |           |
|         |     |      |           | * |          |   |       |           |
|         |     |      |           | * |          |   |       |           |
|         |     |      |           | ( |          |   |       |           |
|         |     |      |           | N |          |   |       |           |
|         |     |      |           | O |          |   |       |           |
|         |     |      |           | T |          |   |       |           |
|         |     |      |           | E |          |   |       |           |
|         |     |      |           | : |          |   |       |           |
|         |     |      |           | T |          |   |       |           |
|         |     |      |           | h |          |   |       |           |
|         |     |      |           | e |          |   |       |           |
|         |     |      |           | C |          |   |       |           |
|         |     |      |           | o |          |   |       |           |
|         |     |      |           | n |          |   |       |           |
|         |     |      |           | f |          |   |       |           |
|         |     |      |           | i |          |   |       |           |
|         |     |      |           | g |          |   |       |           |
|         |     |      |           | u |          |   |       |           |
|         |     |      |           | r |          |   |       |           |
|         |     |      |           | a |          |   |       |           |
|         |     |      |           | t |          |   |       |           |
|         |     |      |           | i |          |   |       |           |
|         |     |      |           | o |          |   |       |           |
|         |     |      |           | n |          |   |       |           |
|         |     |      |           | M |          |   |       |           |
|         |     |      |           | a |          |   |       |           |
|         |     |      |           | n |          |   |       |           |
|         |     |      |           | a |          |   |       |           |
|         |     |      |           | g |          |   |       |           |
|         |     |      |           | e |          |   |       |           |
|         |     |      |           | m |          |   |       |           |
|         |     |      |           | e |          |   |       |           |
|         |     |      |           | n |          |   |       |           |
|         |     |      |           | t |          |   |       |           |
|         |     |      |           | O |          |   |       |           |
|         |     |      |           | f |          |   |       |           |
|         |     |      |           | f |          |   |       |           |
|         |     |      |           | i |          |   |       |           |
|         |     |      |           | c |          |   |       |           |
|         |     |      |           | e |          |   |       |           |
|         |     |      |           | d |          |   |       |           |
|         |     |      |           | o |          |   |       |           |
|         |     |      |           | e |          |   |       |           |
|         |     |      |           | s |          |   |       |           |
|         |     |      |           | n |          |   |       |           |
|         |     |      |           | o |          |   |       |           |
|         |     |      |           | t |          |   |       |           |
|         |     |      |           | v |          |   |       |           |
|         |     |      |           | e |          |   |       |           |
|         |     |      |           | r |          |   |       |           |
|         |     |      |           | i |          |   |       |           |
|         |     |      |           | f |          |   |       |           |
|         |     |      |           | y |          |   |       |           |
|         |     |      |           | c |          |   |       |           |
|         |     |      |           | i |          |   |       |           |
|         |     |      |           | t |          |   |       |           |
|         |     |      |           | i |          |   |       |           |
|         |     |      |           | z |          |   |       |           |
|         |     |      |           | e |          |   |       |           |
|         |     |      |           | n |          |   |       |           |
|         |     |      |           | s |          |   |       |           |
|         |     |      |           | h |          |   |       |           |
|         |     |      |           | i |          |   |       |           |
|         |     |      |           | p |          |   |       |           |
|         |     |      |           | i |          |   |       |           |
|         |     |      |           | n |          |   |       |           |
|         |     |      |           | f |          |   |       |           |
|         |     |      |           | o |          |   |       |           |
|         |     |      |           | r |          |   |       |           |
|         |     |      |           | m |          |   |       |           |
|         |     |      |           | a |          |   |       |           |
|         |     |      |           | t |          |   |       |           |
|         |     |      |           | i |          |   |       |           |
|         |     |      |           | o |          |   |       |           |
|         |     |      |           | n |          |   |       |           |
|         |     |      |           | . |          |   |       |           |
|         |     |      |           | ) |          |   |       |           |
|         |     |      |           | * |          |   |       |           |
|         |     |      |           | * |          |   |       |           |
+---------+-----+------+-----------+---+----------+---+-------+-----------+
|         |     |      |           |   |          |   |       |           |
+---------+-----+------+-----------+---+----------+---+-------+-----------+
| 9\. IP  | Co  |      |           |   | Is this  |   |       |           |
| A       | mpu |      |           |   | a        |   |       |           |
| ddress: | ter |      |           |   | firewall |   |       |           |
|         | \'s |      |           |   | IP       |   |       |           |
|         | sta |      |           |   | address? |   |       |           |
|         | tic |      |           |   | Yes      |   |       |           |
|         | (   |      |           |   | (Provide |   |       |           |
|         | not |      |           |   | Below)   |   |       |           |
|         | dy  |      |           |   | No       |   |       |           |
|         | nam |      |           |   |          |   |       |           |
|         | ic) |      |           |   |          |   |       |           |
|         | IP  |      |           |   |          |   |       |           |
|         | ad  |      |           |   |          |   |       |           |
|         | dre |      |           |   |          |   |       |           |
|         | ss: |      |           |   |          |   |       |           |
+---------+-----+------+-----------+---+----------+---+-------+-----------+
|         |     |      |           |   |          |   |       |           |
+---------+-----+------+-----------+---+----------+---+-------+-----------+
| 10\.    |     |      |           |   |          |   |       |           |
| Level   |     |      |           | R |          | G |       | Adm       |
| of user |     |      |           | e |          | a |       | in./Tech. |
| pri     |     |      |           | g |          | t |       |           |
| vileges |     |      |           | u |          | e |       |           |
| a       |     |      |           | l |          | k |       |           |
| fforded |     |      |           | a |          | e |       |           |
| to the  |     |      |           | r |          | e |       |           |
| a       |     |      |           | U |          | p |       |           |
| ccount: |     |      |           | s |          | e |       |           |
|         |     |      |           | e |          | r |       |           |
|         |     |      |           | r |          |   |       |           |
+---------+-----+------+-----------+---+----------+---+-------+-----------+
| 11\.    |     |      |           |   |          |   |       |           |
| System, |     |      |           |   |          |   |       |           |
| or      |     |      |           |   |          |   |       |           |
| group   |     |      |           |   |          |   |       |           |
| of      |     |      |           |   |          |   |       |           |
| s       |     |      |           |   |          |   |       |           |
| ystems, |     |      |           |   |          |   |       |           |
| for     |     |      |           |   |          |   |       |           |
| which   |     |      |           |   |          |   |       |           |
| an      |     |      |           |   |          |   |       |           |
| account |     |      |           |   |          |   |       |           |
| is      |     |      |           |   |          |   |       |           |
| being   |     |      |           |   |          |   |       |           |
| re      |     |      |           |   |          |   |       |           |
| quested |     |      |           |   |          |   |       |           |
+---------+-----+------+-----------+---+----------+---+-------+-----------+
|         |     |      |           |   |          |   |       |           |
| 450/ESC |     |      |           |   |          |   |       |           |
| 450     |     |      |           |   |          |   |       |           |
| .1/NIMO |     |      |           |   |          |   |       |           |
| 452/SN  |     |      |           |   |          |   |       |           |
| 453/GN  |     |      |           |   |          |   |       |           |
| 4       |     |      |           |   |          |   |       |           |
| 54/TDRS |     |      |           |   |          |   |       |           |
| 456/SNE |     |      |           |   |          |   |       |           |
| 45      |     |      |           |   |          |   |       |           |
| 8/ECANS |     |      |           |   |          |   |       |           |
+---------+-----+------+-----------+---+----------+---+-------+-----------+
| 12\.    |     |      |           |   |          |   |       |           |
| Support |     |      |           |   |          |   |       |           |
| Co      |     |      |           |   |          |   |       |           |
| mments: |     |      |           |   |          |   |       |           |
| **(List |     |      |           |   |          |   |       |           |
| O       |     |      |           |   |          |   |       |           |
| fficial |     |      |           |   |          |   |       |           |
| Relat   |     |      |           |   |          |   |       |           |
| ionship |     |      |           |   |          |   |       |           |
| to ESC, |     |      |           |   |          |   |       |           |
| Ro      |     |      |           |   |          |   |       |           |
| le/Type |     |      |           |   |          |   |       |           |
| Support |     |      |           |   |          |   |       |           |
| P       |     |      |           |   |          |   |       |           |
| rovided |     |      |           |   |          |   |       |           |
| to ESC, |     |      |           |   |          |   |       |           |
| CCB     |     |      |           |   |          |   |       |           |
| Parti   |     |      |           |   |          |   |       |           |
| cipant, |     |      |           |   |          |   |       |           |
| etc.)** |     |      |           |   |          |   |       |           |
+---------+-----+------+-----------+---+----------+---+-------+-----------+
|         |     |      |           |   |          |   |       |           |
+---------+-----+------+-----------+---+----------+---+-------+-----------+
| # Ackn  |     |      |           |   |          |   |       |           |
| owledge |     |      |           |   |          |   |       |           |
| ment St |     |      |           |   |          |   |       |           |
| atement |     |      |           |   |          |   |       |           |
|         |     |      |           |   |          |   |       |           |
| Unaut   |     |      |           |   |          |   |       |           |
| horized |     |      |           |   |          |   |       |           |
| use of  |     |      |           |   |          |   |       |           |
| the     |     |      |           |   |          |   |       |           |
| c       |     |      |           |   |          |   |       |           |
| omputer |     |      |           |   |          |   |       |           |
| a       |     |      |           |   |          |   |       |           |
| ccounts |     |      |           |   |          |   |       |           |
| and     |     |      |           |   |          |   |       |           |
| c       |     |      |           |   |          |   |       |           |
| omputer |     |      |           |   |          |   |       |           |
| re      |     |      |           |   |          |   |       |           |
| sources |     |      |           |   |          |   |       |           |
| to      |     |      |           |   |          |   |       |           |
| which I |     |      |           |   |          |   |       |           |
| am      |     |      |           |   |          |   |       |           |
| granted |     |      |           |   |          |   |       |           |
| access  |     |      |           |   |          |   |       |           |
| is a    |     |      |           |   |          |   |       |           |
| vi      |     |      |           |   |          |   |       |           |
| olation |     |      |           |   |          |   |       |           |
| of      |     |      |           |   |          |   |       |           |
| Section |     |      |           |   |          |   |       |           |
| 799,    |     |      |           |   |          |   |       |           |
| Title   |     |      |           |   |          |   |       |           |
| 18,     |     |      |           |   |          |   |       |           |
| U.S.    |     |      |           |   |          |   |       |           |
| Code;   |     |      |           |   |          |   |       |           |
| cons    |     |      |           |   |          |   |       |           |
| titutes |     |      |           |   |          |   |       |           |
| theft;  |     |      |           |   |          |   |       |           |
| and is  |     |      |           |   |          |   |       |           |
| pun     |     |      |           |   |          |   |       |           |
| ishable |     |      |           |   |          |   |       |           |
| by law. |     |      |           |   |          |   |       |           |
| I       |     |      |           |   |          |   |       |           |
| und     |     |      |           |   |          |   |       |           |
| erstand |     |      |           |   |          |   |       |           |
| that I  |     |      |           |   |          |   |       |           |
| am the  |     |      |           |   |          |   |       |           |
| only    |     |      |           |   |          |   |       |           |
| ind     |     |      |           |   |          |   |       |           |
| ividual |     |      |           |   |          |   |       |           |
| to      |     |      |           |   |          |   |       |           |
| access  |     |      |           |   |          |   |       |           |
| these   |     |      |           |   |          |   |       |           |
| a       |     |      |           |   |          |   |       |           |
| ccounts |     |      |           |   |          |   |       |           |
| and     |     |      |           |   |          |   |       |           |
| will    |     |      |           |   |          |   |       |           |
| not     |     |      |           |   |          |   |       |           |
| kn      |     |      |           |   |          |   |       |           |
| owingly |     |      |           |   |          |   |       |           |
| permit  |     |      |           |   |          |   |       |           |
| access  |     |      |           |   |          |   |       |           |
| by      |     |      |           |   |          |   |       |           |
| others  |     |      |           |   |          |   |       |           |
| without |     |      |           |   |          |   |       |           |
| written |     |      |           |   |          |   |       |           |
| ap      |     |      |           |   |          |   |       |           |
| proval. |     |      |           |   |          |   |       |           |
| I       |     |      |           |   |          |   |       |           |
| und     |     |      |           |   |          |   |       |           |
| erstand |     |      |           |   |          |   |       |           |
| that my |     |      |           |   |          |   |       |           |
| misuse  |     |      |           |   |          |   |       |           |
| of      |     |      |           |   |          |   |       |           |
| a       |     |      |           |   |          |   |       |           |
| ssigned |     |      |           |   |          |   |       |           |
| ac      |     |      |           |   |          |   |       |           |
| counts, |     |      |           |   |          |   |       |           |
| and my  |     |      |           |   |          |   |       |           |
| ac      |     |      |           |   |          |   |       |           |
| cessing |     |      |           |   |          |   |       |           |
| others' |     |      |           |   |          |   |       |           |
| a       |     |      |           |   |          |   |       |           |
| ccounts |     |      |           |   |          |   |       |           |
| without |     |      |           |   |          |   |       |           |
| author  |     |      |           |   |          |   |       |           |
| ization |     |      |           |   |          |   |       |           |
| is not  |     |      |           |   |          |   |       |           |
| a       |     |      |           |   |          |   |       |           |
| llowed. |     |      |           |   |          |   |       |           |
| I       |     |      |           |   |          |   |       |           |
| und     |     |      |           |   |          |   |       |           |
| erstand |     |      |           |   |          |   |       |           |
| that    |     |      |           |   |          |   |       |           |
| thi     |     |      |           |   |          |   |       |           |
| s/these |     |      |           |   |          |   |       |           |
| sy      |     |      |           |   |          |   |       |           |
| stem(s) |     |      |           |   |          |   |       |           |
| and     |     |      |           |   |          |   |       |           |
| re      |     |      |           |   |          |   |       |           |
| sources |     |      |           |   |          |   |       |           |
| are     |     |      |           |   |          |   |       |           |
| subject |     |      |           |   |          |   |       |           |
| to      |     |      |           |   |          |   |       |           |
| mon     |     |      |           |   |          |   |       |           |
| itoring |     |      |           |   |          |   |       |           |
| and     |     |      |           |   |          |   |       |           |
| rec     |     |      |           |   |          |   |       |           |
| ording. |     |      |           |   |          |   |       |           |
| I       |     |      |           |   |          |   |       |           |
| further |     |      |           |   |          |   |       |           |
| und     |     |      |           |   |          |   |       |           |
| erstand |     |      |           |   |          |   |       |           |
| that    |     |      |           |   |          |   |       |           |
| failure |     |      |           |   |          |   |       |           |
| to      |     |      |           |   |          |   |       |           |
| abide   |     |      |           |   |          |   |       |           |
| by      |     |      |           |   |          |   |       |           |
| these   |     |      |           |   |          |   |       |           |
| pro     |     |      |           |   |          |   |       |           |
| visions |     |      |           |   |          |   |       |           |
| may     |     |      |           |   |          |   |       |           |
| con     |     |      |           |   |          |   |       |           |
| stitute |     |      |           |   |          |   |       |           |
| grounds |     |      |           |   |          |   |       |           |
| for     |     |      |           |   |          |   |       |           |
| term    |     |      |           |   |          |   |       |           |
| ination |     |      |           |   |          |   |       |           |
| of      |     |      |           |   |          |   |       |           |
| access  |     |      |           |   |          |   |       |           |
| priv    |     |      |           |   |          |   |       |           |
| ileges, |     |      |           |   |          |   |       |           |
| adminis |     |      |           |   |          |   |       |           |
| trative |     |      |           |   |          |   |       |           |
| action, |     |      |           |   |          |   |       |           |
| and/or  |     |      |           |   |          |   |       |           |
| civil   |     |      |           |   |          |   |       |           |
| or      |     |      |           |   |          |   |       |           |
| c       |     |      |           |   |          |   |       |           |
| riminal |     |      |           |   |          |   |       |           |
| prose   |     |      |           |   |          |   |       |           |
| cution. |     |      |           |   |          |   |       |           |
+---------+-----+------+-----------+---+----------+---+-------+-----------+
| 13\.    |     |      |           |   |          |   | Date  |           |
| Requ    |     |      |           |   |          |   | S     |           |
| estor's |     |      |           |   |          |   | igned |           |
| Si      |     |      |           |   |          |   |       |           |
| gnature |     |      |           |   |          |   |       |           |
+---------+-----+------+-----------+---+----------+---+-------+-----------+

**NGIN Internal/Administrative Use Only**

14\. APPROVED BY:

  ---------------------------- ----------------------------- ------ ---------
  **Code 450:** Associate                                    Date   
  Director for ESC                                                  

  **Code 451:** Chief, NIMO                                  Date   

  **Code 452:** SN Project                                   Date   
  Manager                                                           

  **Code 453:** GN Project                                   Date   
  Manager                                                           

  **Code 454:** TDRS Project                                 Date   
  Manager                                                           

  **Code 456:** SNE Project                                  Date   
  Manager                                                           

  **Code 458** ECANS Project                                 Date   
  Manager                                                           
  ---------------------------- ----------------------------- ------ ---------

15\. Code/Matrix-Related Access Categories: (**Select/insert user access
categories, matrix-related info, & comments for requester.)**

  --------------- ----------- --------- -- --------- --------- --------- --------- ----------- --------- ----------- --------- --------- --------- --------- --------- -------------
  **450**         **450.1**   **452**      **453**   **454**   **456**   **458**   **Group     **450**   **450.1**   **452**   **453**   **454**   **456**   **458**   **Group
                                                                                   Name**                                                                              Name**

                                                                                   Project                                                                             Procurement
                                                                                   Office                                                                              

                                                                                   Project                                                                             Risk Manager
                                                                                   Mgt. & Res                                                                          

                                                                                   Project                                                                             PAAC
                                                                                   Team                                                                                

                                                                                   Civil                                                                               ITT
                                                                                   Servants                                                                            

                                                                                   Public                                                                              Honeywell
                                                                                                                                                                       (NENS)

                                                                                   CMO                                                                                 SGT (NENS)

                                                                                   DMO                                                                                 JPL

                                                                                   Resources                                                                           Other:

  **Comments:**                                                                                                                                                        
  --------------- ----------- --------- -- --------- --------- --------- --------- ----------- --------- ----------- --------- --------- --------- --------- --------- -------------