1. KEY CONTROL FORM


KEY CONTROL FORM

                 

              Date:

 

Name of Employee          Campus/Department

 

Employee            Office Phone

 

Please issue above employee key(s) to the following areas (include precise building, room numbers):

 

 

 

 

 

Approved:    _____________________________  _______________________________

       Signature of Department Head    Title

 

 

       _____________________________  _________________________________

       Key Control Manager      Date

 

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Issuance of Keys- - - - - - - - - - - - - - - - - - - - - - - - - - -

I acknowledge receipt of the key(s) described above. I understand that all keys are property of the College and it is a violation of College policy to duplicate or to have duplicated any key issued by the College. I further acknowledge responsibility and accountability for this key(s). I will report loss or theft of the key(s) to Campus Police immediately and will return key(s) to my department head at time of separation, termination or retirement from the College. I further agree to remain knowledgeable of and abide by the College’s Controlled Access policy while in possession of the key(s).

__________________________________    _________________________________

Employee’s Signature          Date

 

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Return of Key(s)- - - - - - - - - - - - - - - - - - - - - - - - - -

The above key(s) has been returned to the Key Control Manager.

 

__________________________________    _________________________________

Signature of Key Control Manager      Date

 

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Issuance of Replacement Key(s)- - - - - - - - - - - - - - - - - - -

The above key(s) have been lost or stolen. Replacement keys have been issued to the employee.

 

__________________________________    _________________________________

Signature of Employee          Date

 

__________________________________    _________________________________

Signature of Key Control Manager      Date

Form 1370/001 (3/05)

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