Key Requisition Form

FACILITIES PLANNING, MANAGEMENT AND OPERATIONS
KEY REQUISITION
(Fill in the blanks and print out the form)

Department:		Date of Request
Name of Building:		Room/Location
Key Issued To:	^{Typed Name}	__________________________________ ^{Signature (Required)}

Reason for Key Request:

CORE NUMBER(S)	QUANTITY	DESCRIPTION	LOCKSMITH’S INITIALS
			__________
			__________
			__________
			__________
			__________

Approved:	_________________________________ Department Head		__________________________________ Vice President (Signature required for request of keys to outer doors of building)
	_________________________________ Executive Director/Facilities

NOTE: Please allow one to three (1-3) working days for keys to be processed. Keys will be issued from 10 a.m. to 5 p.m. Monday–Thursday. Please call 274-6162 in advance and ask for the Key Control Clerk.

Notified to pick up key(s): _____________________ Date: ________________

Key(s) picked up by: _________________________ Date: _______________
Signature
(must be picked up by person who will use the keys)

* A $100.00 charge will be assessed for replacement of a lost key.

REVISED
10/27 CVC