Security Code Authorization and Receipt Form

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EMAIL COMPLETED FORM TO: maint@asumidsouth.edu

Requesting Individual:	Date:

Employee ID:

I have been assigned an access code to enter the checked building(s) after hours.

ADMIN	ADWIRE	AH	FED EX	JJC	MAINT

MB	MH	NC	RC	SG	WELDING

TC	UC	WC/GYM

Comments:

The access code is used to automatically record entrants into the facilities within the campus computerized security system. Please use discretion in exposing the code to others.

Approvals for Issuing Security Authorization Code

Date:

Date:

Date:

My signature is acknowledgment that I am responsible for the use of the security code assigned to me.

Date:

FOR MAINTENANCE USE ONLY:

Code Assigned:

Name:

Date: