FACILITY ACCESS AUTHORIZATION REQUEST
Systems and Procedures
A Division of The Corporate Controller's Office
IN

FACILITY ACCESS AUTHORIZATION REQUEST

Table of Contents:


Purpose:

The Facility Access Authorization Request form is used to grant authority for an individual to access University locations during times when those locations are locked. Such authorization acknowledges that the individual to whom access is assigned has the authority and the functional responsibility to enter those locations. The person to whom access is being granted must read and agree to comply with Policy AD68 University Access prior to receiving the access requested. This form is administered by the Access Coordinator, who will record the approval of such access requests and maintain this document in their files. This is a permanent record as long as the key(s), access device, and clearance issuances are outstanding to that individual.

General Information:

The form must be completed by the Requestor, Immediate Supervisor/Sponsor, and Next Level Manager (as applicable). The Requestor must read policy AD68, as well as the "AD68 Advisement Statement" and other information on the form. The Immediate Supervisor/Sponsor, and Next Level Manager (as applicable) will sign/date the form, affirming that the Requestor has been advised of their responsibilities under policy AD68 and that they have provided a copy of the policy, if requested.

Final processing will occur as specified in "Where to Send Completed Forms," below.

Exhibit and Instructions:

To view document exhibits, click on link below:

Facility Access Authorization Request 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 adobe.psu.edu. If Adobe Acrobat Pro better suits your needs, contact your IT support staff person for purchasing and installation assistance.

Accessing GURU Forms:

GURU PDF forms are designed for use with Adobe Acrobat Reader or Adobe Acrobat Pro. Each browser (Chrome, Firefox, Internet Explorer, Microsoft Edge, 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 examples, Nuance). It has been brought to the attention of the Office of Systems and Procedures that PDF forms do not function appropriately when accessed using Firefox and/or Microsoft Edge. In order to access any of the forms on GURU and have the fill-and-print functionality work properly, the end-user must access the GURU website using Google Chrome.

The latest version of Adobe Acrobat Reader is available for free. Contact your IT support staff person for downloading assistance, if/as needed. If Adobe Acrobat Pro better suits your needs, contact your IT support staff person for purchasing and installation assistance.

Web-based Documents:

Clicking the form download icon on any of the form instruction pages on GURU will open a web-based version of the form. While it appears to have fill-and-print fields available, not all functionality may be available for use (i.e. digital ID fields). With some exceptions (see below), it will be necessary to convert these web-based documents to PDF documents.

Converting Web-based Documents to PDF Documents:

In order to have a version with all PDF capabilities enabled, click the "Fill & Sign in Acrobat" or "Open with Acrobat" icon located in the upper right-hand corner of the screen. This icon must be clicked before entering any information. A new versions of the document will open. Complete this version and save the document in a location where you will be able to locate it.

If, upon opening the PDF in Google Chrome, the Fill & Sign in Acrobat icon does not appear in the upper right-hand corner of the screen, it will be necessary to enable Adobe Acrobat extension. Please visit Enable Adobe Acrobat extension for Google Chrome for instructions to enable Adobe Acrobat extension.

Exceptions:

Combining PDF Documents:

There may be times when it is necessary to combine multiple PDF documents into a single document for submission. In those instances, complete the following steps:

Repeat this process for each document that will be combined (each file name must be different from the previous)

Applying Digital ID's on PDF's (general instructions):

This form has the Digital ID (applying an electronic signature to the document) process enabled. If, upon opening the PDF in Google Chrome, the following does not appear in the upper right-hand corner of the screen, it will be necessary to enable Adobe Acrobat extension

Image of Adobe Acrobat Fill-and-Sign bar

Please visit the following for instructions to enable Adobe Acrobat extension:

Enable Adobe Acrobat extension for Google Chrome

Complete all fill-and-print form fields before completing the signature process:

  1. Open the Facility Access Authorization Form
  2. Before entering any information, click the "Fill-and-Sign in Acrobat" (see above) icon or click the "fill-and-sign" option (looks like a pen nib) located on the right-hand column within Adobe Acrobat, or click "Tools" from the tool bar on the upper left-hand side of the screen and click "Open" under the Fill & Sign option
  3. Complete all fill-and-print fields
  4. Once the form is complete, click in the signature form field and either:
    • select your digital ID and click continue, or
    • create your digital ID, select your digital ID, and click continue
  5. Review the information in the appearance box and click sign
  6. You will be required to save a copy of the document (the digital signature is not applied until the form is saved)
    • A pop-up window opens with the file name containing facility-access-authorization-form in the File name field. To the end of the file name add a dash and the requesters last name, a dash, and their first name in all lower case (i.e., facility-access-authorization-smith-mary)
    • Select a location where you will be able to retrieve the document
    • Click Save
  7. Close the form version appearing on your screen
  8. Open the version containing the requesters last and first names saved in the previous steps
  9. Verify that the digital ID appears on the document
  10. Close the document

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 Facility Access Authorization Request
Document: Ultimate Distribution: Retention Periods: Disposition Method:
Original Requesting Department's Access Coordinator Retained 2 years after the access device is returned, and/or clearances are removed Paper document = Secure Bin disposal or shred

Electronic document and data = delete and empty recycle bin
1st Copy Requestor

A signed copy, containing all appropriate signatures, must be provided by the Access Coordinator to the Requestor
Retained at the Requestors discretion - - - - -
2nd Copy Requestors Supervisor

A signed copy, containing all appropriate signatures, may be provided by the Access Coordinator
Retained at the Supervisor's discretion but in no case longer than the original document retention requirements Paper document = Secure Bin disposal or shred

Electronic document and data = delete and empty recycle bin
3rd Copy If outside the Requestors home area:
Access Coordinator of the facility being accessed, along with copy of confirming email to Requesting Department's Access Coordinator
Retained 2 years after the access device is returned, and/or clearances are removed Paper document = Secure Bin disposal or shred

Electronic document and data = delete and empty recycle bin

Where to Send Completed Forms:

Access Requests WITHIN the Requestors Home Area

The form is forwarded to the requesting department's Access Coordinator. The requesting department's Access Coordinator will review the request, and if acceptable, sign and date, affirming that they have reviewed the details of the access request and they concur with the request for access.

Access Requests OUTSIDE the Requestors Home Area

The form is forwarded to the requesting department's Access Coordinator. If the request is outside the Requestors home area, the Requestors Home Area Access Coordinator must contact the Access Coordinator of the facility to which access is being requested for permission to access the facility. The discussion and decision to grant access (or not grant) must be substantiated through the exchange of a confirming email between the requesting department's Access Coordinator and the Access Coordinator of the facility to which access is being requested. Once granted and confirmed, the requesting department's Access Coordinator will sign and date, affirming that they have reviewed the details of the access request and access permission has been authorized. If permission is not granted, the form will be retained as evidence of the decision. Copies of the confirming or denial emails (as applicable) must be retained by the both Access Coordinators involved for proper audit trail.

Once approved, and prior to receiving the appropriate access device from the requesting department's Access Coordinator, the Requestor must sign and date, affirming that they have been advised of policy AD68, are aware of their responsibilities in receiving access, and that in accepting keys and/or ACDs from the Access Coordinator, agree to comply in full with the terms specified on the form and all related University policies. The Access Coordinator will issue the access devices requested to the Requestor, along with a signed copy of the form. A signed copy of the form will also be provided to the department/company requesting the issue. The Access Coordinator will retain the signed, original copy of the form for their records. For access requests OUTSIDE the Requestors home area, a signed copy of the form will be forwarded to the Access Coordinator of the facility being accessed.

Contact Information:

For questions, additional details, or to request changes to this form, contact your Access Coordinator.

Cross References:


(03Sept2021)