Requesting Level A or Level B Entity Name (include office symbol and Address):	Date (mm/dd/yyyy):	Network Classification:
Remaining Characters		* Note: Connecting AIS data feeds to networks classified Confidential or higher is not authorized.
Government or USCG Port Partner Point of Contact:	Email Address:	Phone:
Technical Point of Contact:	Email Address:	Phone:
System Owner (SO):	Email Address:	Phone:
Program Manager (PM):	Email Address:	Phone:
Approval Official (AO):	Email Address:	Phone:
Information System Security Officer (ISSO):	Email Address:	Phone:
Information System Security Manager (ISSM):	Email Address:	Phone:
If the feed is to a contractor supporting the Agency effort, please provide contract information, as applicable:
Contractor/Vendor Name:	Contract Number:	Contractor End Date (mm/dd/yyyy):
Provide a detailed description of intended use of AIS data feed. (e.g., C2PC, WebCOP, MISLE, EGIS, MARVIEW, etc.)
Remaining Characters
Geographical Area Of Interest:
Remaining Characters
Number of Data Feeds
1 2 3 4 5 6 7 8 9 10
Justification for any additional feeds:(greater than one)
Remaining Characters
Data Feed Type:
With Duplicate Messages
Without Duplicate Messages
Period Of Interest (DHS Policy 4300A states a maximum of 3 years or length of government contract, whichever is shorter), use [mm/dd/yyyy] format:
From:	To:

Important Notice: An Interconnection Security Agreement (ISA) is required for all data feed connections. The processing time to obtain approval and all required signatures on the ISA could take up to 90 days. Once the ISA has been approved by the AIS Authorizing Official, the requestor will have 60 DAYS to establish their connection to the AIS. If no connection has been established by the end of the 60-Day period, the connection request will be terminated and the requestor will be required to initiate a new Data Feed request.

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