Attachment I
Key Issuance Form
NAME: ______________________________________________________________
Circle One: Faculty Staff Student
Address: _____________________________________________________________
TXSTATE ID#: ______________________ PHONE NO: _____________________
DEPARTMENT: ______________________________________________________
ACCOUNT NO.: __________________________
I UNDERSTAND AND AGREE THAT:
1. I am responsible for the university keys issued to me and for immediately reporting their loss or theft to the University Police Department as well as to my supervisor or department head.
2. I may not transfer or loan my keys to another person. I understand that unauthorized duplication, use, or possession of university keys is not allowed.
3. I know only Texas State Access Services may duplicate university keys.
4. I
will return all keys immediately to
SIGNATURE: __________________________________________ DATE: ________________
KEY# SERIAL# DATE LOST/DATE RETURNED SIGNATURE