KEY & ACCESS CARD ISSUE FORM Form Code: HSW-F21

 HSWAGATA BUDDHA TOOTH RELICS PRESERVATION MUSEUM

KEY & ACCESS CARD ISSUE FORM

Form Code: HSW-F21

Date: ____ / ____ / ______

1. PERSONAL DETAILS

   1.1 Name: __________________________________________

   1.2 Role: __________________________________________

   1.3 Department / Unit: _____________________________

2. ISSUED KEYS / CARDS

   -----------------------------------------------------------------------

   | No. | Key / Card Number | Area or Room         | Date Returned      |

   -----------------------------------------------------------------------

   |  1  |                    |                      |                    |

   |  2  |                    |                      |                    |

   |  3  |                    |                      |                    |

   |  4  |                    |                      |                    |

   |  5  |                    |                      |                    |

   -----------------------------------------------------------------------

3. CONDITIONS OF USE

   I understand and agree that:

   - Keys and access cards are for my work duties only.

   - I will not lend them to other people.

   - I will report loss or theft immediately.

   - I will return all keys and cards when my work ends.

4. SIGNATURES

   Person Receiving Keys / Cards:

   Name: ________________________________________

   Signature: ________________ Date: ____/____/____

   Issued By (Staff Name): _______________________

   Signature: ________________ Date: ____/____/____

For Office Use Only:

   All keys / cards returned on:

   Date: ____/____/____   Checked By: ____________