1. uNID(U of U Student ID - e.g. u0123456)
2. First Name
3. Last Name
4. Position

   Faculty Staff Student Other
5. Email

1. Building Number Select Location 83 = JFB 10 = South Physics 19 = INSCC
2. Room Number
3. Key Number
4. Is the key lost?

   Yes

1. Room Type

   Office Classroom Other Lab
2. Room Number
3. Key Number
4. Authorization Email

I acknowledge that I, the key requester, have read, reviewed, and understood ALL the conditions of key responsibility outlined in the University of Utah Key Policy 3-234, including the following:

• I am responsible for this key.
• I will NOT lend, transfer, or swap this key with anyone else, ever.
• I will return this exact same key to the main office (201 JFB) when my need or employment terminates.
• If my key number doesn't match the number in the department records, it is up to me to track down and return my original key.
• I understand any violations of any of the above will lead to forfeiture of my deposit, and/or my suspension or termination from the University of Utah.

1. I have read, understood and acknowledge the conditions of key responsibility as outlined above. I agree to accept and abide by these terms & conditions?

   Yes
2. Special Instruction or Additional Information