Key Request Form

Key Request Form
Take completed form to the front desk in the Facilities Management Building. Pay deposit or sign for payroll deduction. You will be contacted when keys are ready to be picked up. Keys will be ready within three business days. Questions regarding key issues should be directed to Facilities Management at 626-6331.
Original Issue	Lost Key	Broken Key	Exchange (Approval Required)
Person Requesting Key(s)

Last Name:

First Name:

MI:

Employee W Number or Student ID:

Phone Number:

Department/Division:

Position:

Faculty	Staff	Student	Hourly	Other
Approving Signatures (See Lock & Key Policy in PPM for Key Approval) Chair/Director/Dean ___________________________________________ Date: __________________ Vice President: _______________________________________________ Date: __________________

One Time Key Deposit - WSU Personnel (Select one from below.)

	$25.00 paid to cashier's office.
	$25.00 paid to FM Business Center. Cash Check #_____ Received by: _________________
	$25.00 deducted from one paycheck
	$12.50 deducted from two paychecks (total amount deducted will be $25.00).
	$6.25 deducted from four paychecks (total amount deducted will be $25.00).
	(Employee W Number is required for payroll deduction.)

Pursuant to Weber State University's Lock and Key Policy (PPM 5-44), I understand that any keys issued to me must be returned upon transferring to another department or upon termination of employment with the University. I agree by my signature below, that if I do not return the keys in accordance with this Agreement or PPM 5-44, I forfeit my deposit and my transcripts and paychecks may be held until keys are returned or a replacement fee is paid. Keys will remain the property of the University and may not be duplicated. If I have chosen payroll deduction for the deposit, I authorize the payroll department to take the amount from my paycheck(s).
_____________________________________________________________	__________________________
Signature of Person to whom Keys will be issued	Date
"Other Personnel" is defined as anyone working at the University with a need for access to a keyed space, which does not fall in the "WSU Personnel" category. This will include contractors, consultants, visitors, etc. A deposit of $100.00 per key will be required. This deposit will be refunded upon the return of said key or keys to the Facilities Management Business Office. Please fill out the "Other Personnel Form" Look here for a Key FAQs.

Verified By Facilities Business Office (Initials)_________