DCPDS ACCESS FORM VERSION 2.00 23 February 2011

DCPDS USER ACCOUNT REQUEST

Instructions for completing this form are shown on next page

 New Account Modify Existing Account Inactivate Account

SECTION I: USER INFORMATION (USER MUST COMPLETE):

Name (Last, First MI) 

 

Check the choice that applies:

Civilian Employee Gov’t Contractor Military 

SSN (Last four):

xxx-xxPP/Series/Grade:  

Position Title: 

Activity/Organizational Code: 

Phone (Include Area Code and DSN) 

 

Email Address: 

 

I assume the responsibility for the data and system to which I am granted access. I will not exceed my 

authorized access. User’s Signature: 

 Date: 

SECTION II: (SUPERVISOR IS TO COMPLETE INFORMATION BELOW)

Proposed 

Group Inbox 

Title(s): 

USER OPTIONS: Please check all the following options that apply to this user:

Personnelist Initiate RPA’s

Administrative Support Sign RPA as Requesting Offcl

Manager/Supervisor Sign RPA as Authorizing Offcl

Other: Approves RPA’s (DLA HR) Only

Review RPA’s only

PRINTER NAME (IF APPLICABLE): 

USER ACCESS : DCPDS: CSU (if applicable): 

LIMIT USER ACCESS TO 

THE FOLLOWING 

ACTIVITIES: 

LIMIT USER ACCESS TO 

THE FOLLOWING 

ORGANIZATIONS: 

I certify this user requires access as requested in the performance of his/her job function.

Supervisor’s Signature: Date: 

Human Resources POC Signature: Date:

Notes/ Remarks:

PRIVACY ACT STATEMENT

Public Law 99-474, the counterfeit Access Device and Computer Fraud and Abuse Act of 1984, authorized collection of this information. The 

information will be used to verify that you are an authorized user of a Government automated information system (AIS) and/or to verify your level 

of Government security clearance. Although disclosure of the information is voluntary, failure to provide the information may impede or prevent the 

processing of your Modern DCPDS User Account Request. Disclosure of records or the information contained theirin may be specifically disclosed 

outside the DOD according to the “Blanket routine Uses” set for at the beginning of the DISA compilation of systems of records, published annually 

in the Federal Register, and the disclosures generally permitted under 5 U.S.C. 552a(b) of the Privacy Act.
DCPDS ACCESS FORM VERSION 2.00 23 February 2011

DCPDS USER ACCOUNT REGISTRATION INSTRUCTIONS

To complete the DCPDS User Account Request form:

SECTION I: USER INFORMATION

1) Are you adding a new account, modifying an existing account or inactivating an 

existing account? Select one 

2) Enter the User’s Last name, First name, Middle Initial (MI) 

3) Type of User: Civilian Employee, Gov’t. Contractor, Military. Select one.

4) Enter the last four of the User’s Social Security Number 

5) Enter the users PP/Series/Grade if the user is military, enter rank in the block.

(e.g., CDR, CAPT, LTCOL, etc).

6) Position Title: Enter the user’s current position title or billet designation.

7) Activity/ Organization Code: Enter the name of the user’s Activity and 

organizational code.

8) Phone: Enter the users work telephone number including area code and DSN Prefix.

9) Email Address: Enter the user’s Internet email address.

10) Users Signature: The user should sign in this block and date.

SECTION II: TO BE COMPLETED BY USER’S SUPERVISOR 

1) Proposed Group Inbox Title(s): List the groupbox name(s) the user will need to 

have access to.

2) User Options (Roles and Responsibilities): Select the responsibility that applies to 

the user (e.g., Manager/Supervisor, Personnelist, etc.) and any roles that also apply to 

the user (e.g., Initiate RPA’s, Sign RPA as Requesting Official etc.)

3) Printer: If a Personnelist list the Printer Name of default printer that needs to be 

established for the user in DCPDS.

4) User Access: Mark if they need access to DCPDS and/or CSU application. CSU access 

is not applicable for all users.

5) User Access to Personnel Records: List the Activities and Organization Codes the 

user will need to be able to access.

6) Supervisor Signature: The User’s Supervisor should sign in this block and date. 

7) Human Resources POC: The User’s Human Resources POC should sign and date in 

this block.

8) Notes/Remarks: Any additional comments

Note: Only a copy signed by the appropriate people and sent through your Human Resources POC will be 

accepted. Your Human Resources POC will then send to DHRS-S, Attn: Nora Stiffler @ nora.stiffler@dla.mil 

or Linda Brumfield @ linda.brumfield@dla.mil.