Key Card Report Form

							Key/Access Card Report Form
This form must accompany all returned keys or access cards and must be submitted when keys or access cards are lost
or stolen. It may be copied as needed.

IMPORTANT: Please report lost keys and access cards immediately, by telephone, to Facilities Management Key
Control, 530-752-3507, then complete and submit this form as soon as possible.


FROM:

                   Department ________________________________________________________________________________


                   Contact Person _____________________________________________________________________________


                   Telephone/E-mail ___________________________________________________________________________
 RETURNED


                    STOLEN
            LOST




                                Key/Card #           Serial #    Dept. Code             Assigned To               Date Lost/Stolen




                             Send completed form to Facilities Management Key Control. Retain a copy for your records.



UC Davis Policy & Procedure Manual Section 360-50                                                                          11/07/2011