Place of Birth
Active Clearance Level Confidential Secret Top Secret
Date Granted
Name and Phone Number of last Security Manager
If your last security clearance was held while in the Military, along with the information requested above, please provide a copy of your DD-214 (member #4).
Please print and mail this information to the following address:
PAR Government Systems Corporation c/o Initial Security Questionnaire 314 South Jay Street Rome, NY 13440
