WSMR DECSYSTEM-20
                   USERID REQUEST AND DIALUP AUTHORIZATION
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1. Requested Action (check one)                  | 2. Printed Name of User
 __          __             __                  |
|__| NEW    |__| CHANGE    |__| CANCEL          |
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3. Organization Name and Mailing Address:        | 4. Phone | a. Commercial
                                                |          |
                                                |          |------------------
                                                |          | b. AUTOVON
                                                |          |
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5. Userid/Mailbox Name
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                            PASSWORD PROTECTION
AR 380-19 prohibits users from revealing passwords to anyone, even though they
may be employed on the same project and hold identical clearances.
_______________________________________________________________________________
6. Signature of User                             |7. Date
                                                |
                                                |
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8. I verify that this user is authorized to (check one or more)
   __
  |__| Use a DDN mailbox on the WSMR DECSYSTEM-20.
   __
  |__| Charge computer runs against a valid WSMR DECSYSTEM-20 project.
   __
  |__| Perform the duties of TASO IAW AR 380-19.
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8a. Printed Name of Supervisor|8b. Signature of Supervisor  |8c. Date
                             |                             |
                             |                             |
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8c. Supervisor's Office Symbol|8d. Supervisor's Phone Number
                             |
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9. TASO:  I verify that (check one):
   __
  |__| This terminal user is authorized to use terminal equipment under my
        jurisdiction.
   __
  |__| I am acting as own TASO and agree to perform the duties of TASO
        IAW AR 380-19.
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9a. Printed Name of TASO      |9b. Signature of TASO         |9c. Date
                             |                              |
                             |                              |
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9d. TASO's Office Symbol      |9e. TASO's Phone Number
                             |
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PLEASE DO NO WRITE BELOW THIS LINE
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10. Request Number   | 11.  __
                    |     |__| Approved as Requested      __
                    |      __                            |__| Rejected
                    |     |__| Changed
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12. Signature of ISSO
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13. Comments


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ASQNC-TWS FORM 91
1 Feb 91
         Replaces STEWS-IM Form 11, 1 Apr 87, which is obsolete.