Document aJD1b8wjxy7kEqmjxBYomwVLb

.,.I. EPA/OCFO/OTS 1300 Pennsylvania Avenue, Northwest Washington D.C. DC 20004 IT ACCESS REQUEST FORM Employee Contractor SEE Section 1 - User Information Date of Request User ID 2/10/2025 Last Name Killian First Name Cole User Location EPA HQ Telephone Number Email Address killian.cole@epa.gov Supervisor or COR (for contractor) Telephone Number Andrew Battin (Compass system owner) Email Address battin.andrew@epa.gov Section 2 - Revised Type of Access: Environment: Middle Initial V New u Remove / Delete Update V Prod Test Training Development User Role(s): Admin 4/ User u Other Change: u Server Change u Access Request u Other Server Name: Explain: Access to Grants data in Compass. Justification (If needed) (contractors only): Background Clearance Status Date Cleared Section 3 - Approval Requestor's Signature Supervisor or COR Signature Security Officer Signature Environment Manager Signature Access Completed by Name Name Name Name Date Date Date Date Date Section 4 - Disclosure I understand that I will have access to data that may be classified as sensitive in nature, and/or Privacy Act information which must be protected from unauthorized disclosure. I am granted access to this information in connection with my official duties on behalf of the U.S. Government. I understand that remotely accessible administrative protocols must be accessed only after connecting to a secure Jump Box. Use of the VPN to access remote administrative protocols is expressly prohibited. I agree to protect this information from loss or compromise while it is in my custody and I will not permit it to come into the possession of unauthorized person(s). I understand that I am subject to the legal restrictions and penalties with respect to the disclosure of Privacy Act data pursuant to the Privacy Act of 1974 (5 U.S.0 Section 552), Public Law 93-579, and the EPA OIRM Directive 2195, Information Security Manual. I further understand that if I use the information to my own advantage, or reveal information to unauthorized individuals, I may be considered to have committed a prohibited act and may be subject to criminal prosecution with possible fine and/or imprisonment. Additionally, such action may result in one or more of the following actions: (1) Suspension of access privileges, (2) Reprimand, (3) Demotion, or (4) Suspension or Removal from duty. I understand that any unauthorized access and/or use of Federal databases or the willful damage or destruction of the files will be prosecuted under applicable Federal laws. Consequences of noncompliance are (1) based on the severity of the violation, (2) at the discretion of management, and (3) through due process of the law. I understand and agree to adhere to the responsibilities contained in this document. v1.7 Updated 7/20/2021 Earthjustice/Sierra Club 2025-EPA-05146 ED_018033_00000404-00001 SC_EVERSPLIT0032043