Offboarding Keycard Access & Keys – Request Form Offboarding Keycard Access and Keys Step 1 of 2 50% Name This field is for validation purposes and should be left unchanged. Preparer Information Preparer / Submitter(Required) I am offboarding myself I am offboarding someone else Preparer Name(Required) Your name First Last Preparer UW Email(Required) Your email Name(Required) Name of individual you are preparing on behalf of. First Last Email(Required) Email of individual you are preparing on behalf of. Employee ID Number (EIN)(Required) EIN of individual whose keycard access is being revoked or keys returned. Reason for Offboarding(Required) Separation from Unit Separation from University Other Offboarding Date(Required) Date that keycard access should be revoked and/or keys returned. MM slash DD slash YYYY Offboarding - Other(Required) Action Reqeust Building(s)(Required) Keycard access or keys to which building(s)? Gerberding Hall Schmitz Hall Both Revocation(Required) Assigned Keys Keycard Access Both Key Numbers(Required) Key Number Sub-Number Add Remove Examples of key numbers and sub-numbers Keycard Access Locations(Required) List the accesses that should be removed. For example: Schmitz exterior door, Gerberding exterior door, and Gerb suite, etc. Additional Information Provide any additional, relevant information on needed action.