UNCW KEY REQUEST FORM Date Sent (m/d/yy): Sheet 1 of SEND completed form to the Locksmith Shop via Email to PhysicalPlantLocksmithShop@uncw.edu

Name & Extension of Person filling out form (in case of questions):

CRT # Work Order #__________________

Instructions to: CRT & WO# assigned by Work Control Administration upon receipt of this form (from Locksmith Shop).

• REQUEST KEYS- Complete Form and Send (with appropriate authorizing signatures).• PICK UP KEYS- Only the Director/Dean of the Department, or the Designated Key Control (DKC) person is permitted to pick up keys.

SIGNATURES of Approval REQUIRED: Dependent on the Level of Key requested (below): Level 1: Grand Masters - Department Head, Dean (or Division AVC), Division VC, Facilities AVC, AND Physical Plant Director.

Level 1 operates multiple locks in multiple buildings Level 2: Master Key- Department Head, Dean (or Division AVC), AND Physical Plant Director.

Level 2 operates master suites (used by more than one department), building masters and exterior doors. Level 3: Operating Key- Department Head.

Level 3 operates office doors, work areas or suites.

PHY 05.120- Key Control Revised: 04/11/2017

REASON FOR KEY REQUEST: Approved by Locksmith. Initial & date : Lost Key (s): Police CAD report must accompany request for Lost Key(s). New Employee (s):

Other (please explain): DEPARTMENT INFORMATION:

Department (print): Dept. Head Name (print):

DKC’s Name (print): DKC’s Phone #:

Dept. Head’s Phone #:

KEYS REQUESTED: Please use Continuation Sheet(s) to request additional keys; indicate # of sheets total (above right) FOR LOCKSHOP USE ONLY

Key Holder’s Name (print): Key Holder’s 850 REQUIRED Building Name Door # QTY Visual Code

Key Level Key Way Code

AUTHORIZING SIGNATURES:

Department Head/ Date: Physical Plant Director/ Date Division AVC /Date

Facilities AVC / Date Printed Name-Key Recipient Signature Received by /Date

Account/ FUND to Charge:

REJECTED by Locksmith. Reason, Initial & date: