Systems and Procedures
A Division of The Corporate Controller's Office


Table of Contents:


The completion and approval of the Access Coordinator Authorization form appoints the said individual as the Access Coordinator for the specified campus, college, department or area, in accordance with Policy AD68 - University Access Policy and Procedure SY2001 - University Access: Clearance, Keys and Access Devices; Authorization, Issuance, and Fees.

General Information:

The Access Coordinator completes and submits this form to the Budget Executive or Administrator for approval. Upon Budget Executive/Administrator approval, the original form will be sent to the University Access Controller, 104 USB 1, University Park. Areas should keep a copy for their records.

If TERMINATING an appointment, the area must complete the "Termination of Appointment" section and send a copy of the form to the University Access Controller, 104 USB 1, University Park, as notification of the change.

Exhibit and Instructions:

To view document exhibits, click on link below:

Access Coordinator Authorization Form Exhibit

Form Requirements:

No form may be used that substitutes for an approved official University form without prior review and approval by the steward of the form/central office, as facilitated by the Office of Systems and Procedures (designated representative of the Corporate Controller). See Policy FN17 - Required Use of Approved University Forms Appearing in the General University Reference Utility (GURU) for full details.

GURU PDF forms are designed for use with Adobe Acrobat Reader or Adobe Acrobat Pro. Each browser (Chrome, Firefox, Internet Explorer, etc) has a built-in PDF viewer making it the default PDF viewer without asking users. These built-in viewers do not necessarily support all features required for PDF Forms. Similarly, many calculations are not supported by other stand alone PDF readers (for example, Nuance). If you experience problems downloading or opening documents, right click on the link on the Forms Locator Screen, select 'Save Link As' (or similar language) and save the file. The document can then be opened in either Adobe Acrobat Reader or Adobe Acrobat Pro from the saved location.

The latest version of Adobe Acrobat Reader is available for free. Contact your IT support staff person for downloading assistance, if/as needed. An Adobe Creative Cloud (CC) account is also available to all Penn State students, faculty, and staff members, at no cost. Sign up for an Adobe Creative Cloud account at If Adobe Acrobat Pro better suits your needs, contact your IT support staff person for purchasing and installation assistance.

If you encounter any difficulties, contact the GURU support staff by submitting a Technical Support Form request or by calling the tech support line at 814-863-8592.

Number of Copies and Ultimate Distribution:

Table of distribution and retention of the Access Coordinator Authorization Form
Ultimate Distribution: Retention Periods:
Original Office of Physical Plant 3 years

Where to Send Completed Forms:

The original form is to be sent to the University Access Controller, 104 USB 1, University Park

Contact Information:

For questions, additional details, or to request changes to this form, please contact the University Access Controller.

Cross References: