Date: [Insert Date]
MEMORANDUM FOR RECORD
Subject: Report of Lost Common Access Card (CAC)
1. I, [Your Name], an employee of [Your Unit/Division/Department], hereby report the loss of my Common Access Card (CAC), effective [Date of Loss]. The details of the incident are as follows:
Employee Name: [Your Name]
Rank/Title: [Your Rank/Title]
Employee ID: [Your Employee ID]
Unit/Division/Department: [Your Unit/Division/Department]
Date of Last Use: [Date of Last Use of the CAC]
Description of the CAC: [Color, chip type, any distinguishing features]
2. The CAC was last used on [Date of Last Use], and I discovered it was missing on [Date of Discovery]. Immediate steps have been taken to mitigate potential security risks associated with the lost CAC:
I have notified my immediate supervisor and the Security Office of the loss.
I have initiated the process for reporting the lost CAC and requesting a replacement.
I have changed passwords and access codes associated with the CAC.
3. I request the support and assistance of the Security Office and relevant personnel in expediting the replacement process and ensuring the security of our systems and facilities.
Contact Information:
Name: [Your Name]
Rank/Title: [Your Rank/Title]
Phone Number: [Your Phone Number]
Email: [Your Email Address]
Supervisor's Information:
Name: [Supervisor's Name]
Rank/Title: [Supervisor's Rank/Title]
Phone Number: [Supervisor's Phone Number]
Email: [Supervisor's Email Address]
4. Please consider this memorandum as a formal notification of the lost CAC, and I appreciate your prompt attention to this matter.
[Your Signature]
[Your Typed Name] [Your Rank/Title] [Your Unit/Division/Department]
