FACILITY ACCESS AUTHORIZATION REQUEST
Table of Contents:
- General Information:
- Exhibit and Instructions:
- Form Requirements:
- Number of Copies and Ultimate Distribution
- Where To Send Completed Forms
- Contact Information
- Cross References
Use of Google Chrome Required
NOTE: Google Chrome must be used to access the GURU website and for completing and/or downloading fill-and-print forms. Firefox, Internet Explorer, and Microsoft Edge browsers do not support all features required for PDF functionality. Substitutes for a University official form (created using a different browser or scanned copies) will be returned along with the request to use the Chrome version.
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.
- This facility authorization grants access only to the Requestor named on this form.
- Access is limited to the areas approved on this form.
- Access is restricted to the specified and approved days and times.
- Access to the facility will be for the approved purpose and by the approved means, as determined by the Access Coordinator.
- Non-employees require a University-employed sponsor, and can only request temporary access. The Sponsor is responsible for all non-employee keys/ACDs.
- Lost or Stolen Keys/ACDs:
- The loss of a key/ACD must be reported immediately to the Access Coordinator by the individual to whom the key/access card has been issued. Completion of a new form will be required.
- If access needs to be changed from those which have been granted herein, the said individual will notify the Access Coordinator for completion of a new Facility Access Authorization Request.
- For questions pertaining to access, please refer to Policy AD68 University Access , or Procedure SY2001 University Access; Clearances, Keys and Access Devices; Authorization, Issuance and Fees.
The form must be completed by the Requestor, Immediate Supervisor/Sponsor, and Access Coordinator. The Requestor must read policy AD68, as well as the "AD68 Advisement Statement" and other information on the form. The Immediate Supervisor/Sponsor, and Access Coordinator 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.
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 form fields. Hovering the computer mouse over any form field will display these instructions.
To view document exhibits, click on link below:
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). 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.
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.
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.
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.
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:
- Click on the appropriate form in GURU
- Complete the fill-and-print boxes on the web-based form
- Click the printer icon located in the upper right-hand corner of the screen
- Change Destination to Microsoft Print to PDF using the drop-down arrow
- Click Print at the bottom of that panel
- Enter a file name in the box at the bottom of the pop-up window and be sure to select a location where you will be able to relocate the document
- Click Save
Repeat this process for each document that will be combined (each file name must be different from the previous)
- Now, open one of the completed PDF documents and on the far right select combine files
- Click Add Files and select the files to be combined
- Click Combine
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
Please visit the following for instructions to enable Adobe Acrobat extension:
Complete all fill-and-print form fields before completing the signature process:
- Open the Facility Access Authorization Form
- 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
- Complete all fill-and-print fields
- 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
- Review the information in the appearance box and click sign
- 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
- Close the form version appearing on your screen
- Open the version containing the requesters last and first names saved in the previous steps
- Verify that the digital ID appears on the document
- Close the document
The Facility Access Authorization Request Form requires multiple signatures. Please complete the following process for obtaining those signatures:
- The requestor completes and saves the form using the naming convention defined above
- The requestor sends an email, with the above referenced document as an attachment, to their supervisor or sponsor
- The supervisor or sponsor opens the document, reviews the document, and applies their digital ID (if approving) as defined in Steps 4, 5, and 6 above and saves the document again (do not change the file name)
- The supervisor or sponsor sends an email, with the above referenced document as an attachment, to the Access Coordinator
- The Access Coordinator opens the document, reviews the document, and applies their digital ID (if approving) as defined in Steps 4, 5, and 6 above and saves the document again (do not change the file name)
- The Access Coordinator provides a copy of the completed for to the requestor and retains the original form following the retention requires outlined below
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
|Document:||Ultimate Distribution:||Retention Periods:||Disposition Method:|
|Original||Requesting Department's Access Coordinator||End of calendar year +3 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
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
|End of calendar year +3 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
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.
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.
For questions, additional details, or to request changes to this form, contact your Access Coordinator.
- 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
- Procedure SY2001 University Access; Clearances, Keys and Access Devices; Authorization, Issuance and Fees