Fillable Key And Lock Requisition Form printable pdf download

NORTH CAROLINA AGRICULTURAL AND TECHNICAL STATE UNIVERSITY

PHYSICAL PLANT

KEY AND LOCK REQUISITION

Directions:

This requisition form must be completed and signed by the requestor and the department head and submitted to the

Appropriate Building Custodian and Vice Chancellor for their approval. The completed form must be submitted to

the Office of the Director of the Physical Plant. (For additional information/instructions see the University Key

Policy.)

1. Location of key and/or lock work:

Building: ______________________________ Department: ________________________________

A. Room Number: _____________ Door Number: _________________ Number of Keys: ________

Room Number: _____________ Door Number: _________________ Number of Keys: ________

B. Outside Door:

Yes _____ No _____ (Give Location) _________________________________

C. Sub-Master Key: Yes _____ No _____

2. Purpose of key(s) and lock work:

______ Additional Personnel

______ Replacement due to breakage

______ Additional Security

______ Replacement for lost/stolen keys (if Lost/Stolen) Date lost or stolen reported to security: ___________

______ Other (Give Reason) __________________________________________________________________

3. Lock Work Requested:

______ Re-key cylinder - new key change.

______ More than one lock to be keyed alike on master system.

______ More than one lock to be keyed alike off master system.

Approvals: (As Required - see University Key Policy)

Date Requested

___________ Requestor: ________________________ Dept. Head:______________________

Dean: _______________________________ or Area Supervisor: _____________________________________

Vice Chancellor:____________________________ Building Custodian: _______________________________

Director of the Physical Plant: __________________________________

Date Completed by Locksmith: ________________ Locksmith: ______________________________________

Issuing Personnel: ___________________________ Received By: ____________________________________

Number of Keys and/or lock work:

No. of door keys received:

_______ Signature of Person Receiving Keys: ________________________

No. of sub-master keys received:

_______ Signature of Person Receiving Keys: ________________________

No. of outside door keys received: _______ Signature of Person Receiving Keys: ________________________

Comments/Explanations:

___________________________________________________________________________________________

PP_KLR(4/97)

Key And Lock Requisition Form