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# DLA Official Forms

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| Form Number:  DLA0926C                                                                                                                                                                                                      |
|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Form Title:  Police Credentials for Separated or Retired Officers                                                                                                                                                           |
| Form Version:  Oct 2014                                                                                                                                                                                                     |
| Status:  Active                                                                                                                                                                                                             |
| Functional Area:  Installation Management                                                                                                                                                                                   |
| Opr:  DM                                                                                                                                                                                                                    |
| Safeguards:  controlled form                                                                                                                                                                                                |
| Electronic:  No                                                                                                                                                                                                             |
| Form Link:                                                                                                                                                                                                                  |
| Type:  Primary                                                                                                                                                                                                              |
| Prescribed:  DLAI 5525.01                                                                                                                                                                                                   |
| Description:  This form will be issued to separated or retired DLA Police Officers and is compliant with a new DoD Instruction, 5525.12, Implementation of the Amended Law Enforcement Officers Safety Act of 2004 (LEOSA). |
| Records Retention:  157.25 Individual Access Files                                                                                                                                                                          |
| Form Audience:                                                                                                                                                                                                              |

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