FACULTY AND STAFF PERMIT REGISTRATION AND AUTHORIZATION FORM
FORM INSTRUCTIONS

To be completd by Department Parking Chair:

1. Select the date the permitted was issued
2. Enter the permit number
3. Enter the Parking Chair Code
4. Select the Pay Frequency from the drop-down list. Options include Bi-weekly or Monthly

To be completed by Employee:

5. Enter the employee's PSU ID#
6. Enter the employee's Last Name
7. Enter the employee's First Name
8. Enter the employee's Middle Initial
9. Enter the employee's complete home address including house number, apartment number (if applicable), street name, city, state, and zip code
10. Enter the employee's work phone number, including area code
11. Enter the employee's personal (cell) phone number, including area code
12. Enter the employee's PSU email address
13. Enter the employee's ADA Placard # (if applicable). A copy of the Americans with Disability Act ID card must be included with this request

Vehicle Information Section:

14. The employee is required to provide their vehicle information on the Manage Vehicle Information page on the Transportation website

Authorizations Section:

15. The employee must provide a hand-written signature or provide their digital ID
16. If the employee provided a hand-written signature, select the date the form was signed. If a digital ID was provided, skip this field

Permit Returned Section:

17. Select the date the permit was returned
18. Select the date Payroll was notified to stop deductions
19. The employee returning the permit must provide a hand-written signature or provide their digital ID. If the employee provides a hand-written siganture include the date the form was signed
20. The Parking Chair must provide a hand-written signature or provide their digital ID. If the Parking Chair provides a hand-written signature include the date the form was signed