Key/CCURE Clearance Issuance Log

Table of Contents

• Purpose
• General Information
  • Access Restrictions
  • Lost, Stolen, & Return of Access Devices
• Exhibit and Instructions
• Form Requirements
• Number of Copies and Ultimate Distribution
• Where To Send Completed Forms
• Contact Information
• Cross References

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Purpose

The Key/CCURE Clearance Issuance Log Form is used by the Access Coordinator to record keys issued to individuals for access to University facilities. Such authorization acknowledges that the individual to whom access is assigned has the authority and the functional responsibility to enter those locations.

The individual to whom access is being granted must read and agree to comply with Policy AD68 University Access prior to receiving access. The Facility Access Authorization Request must also be completed along with the Key Issuance Log form. This form is administered by the Access Coordinator, who will record the authorization of such access and maintain this document per the University Record Retention Schedule.

General Information

Access Restrictions

• Access is limited strictly to the individual and University facilities designated on the Facility Access Authorization Request. No other individual may enter the approved facility using the individual's access privileges
• Access is restricted to the specified and approved days and times
• Access to the facility is only for the agreed upon purposes as determined by the Access Coordinator
• Individuals are not permitted to conduct personal or other business on the premises at any time
• Non-employees require a University-employed sponsor. Sponsor is responsible for all non-employee access
• The Area Access Control Coordinator should be notified if access needs to be updated or terminated

Lost, Stolen, & Return of Access Devices

• Any lost keys, id+ Card, or Access Card must be reported immediately to the Access Coordinator by the individual to whom the access was issued
• A lost or stolen card will result in the immediate termination of access privileges and will be reactivated only after resubmission of a request for access
• Keys and/or Access Cards must be returned on the access end date to the Access Coordinator

Exhibits and Instructions

This form has fill-and-print form fields and digital ID (signature) fields enabled. The PDF version has instructions provided for the type and/or format of information to be included within the fill-and-print form fields. Hovering the computer mouse over any form field within the PDF will display these instructions.

There is no exhibit associate with this document.

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 Associate Vice President for Budget and Finance). Policy FN17 Required Use of Approved University Forms Appearing in the General University Reference Utility (GURU) requires that all form templates must be vetted and approved prior to being published on the GURU website and all such documents having gone through said established approval process must be password protected. Procedure FN2017 Use of Approved Form Templates Appearing on the GURU Website contains completed details pertaining to the required use of University form templates.

Number of Copies and Ultimate Distribution

*Transitory Copy - University Records that have temporary value and, as a result, may be destroyed after they are no longer needed. In no event shall be retained longer than the official copy of the University Record as delineated on the Records Retention Schedule.

Where to Send Completed Forms

Sent as an email attachment along with the Facility Access Request Form to the Access Coordinator.

Contact Information

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

Cross References

• Policy AD35 University Archives and Records Management
• Policy AD68 University Access
• Policy FN17 Required Use of Approved University Forms Appearing in the General University Reference Utility

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