Key Issuance Log
Please complete this log to record the distribution and return of keys. Do not enter any sensitive identification numbers.
Recipient Full Name
*
First Name
Last Name
Department or Unit
*
Key Description or Number
*
Purpose of Key Issuance
Date and Time of Issuance
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Name of Person Issuing Key
*
Expected Return Date (if applicable)
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Key Returned?
*
Yes
No
Signature of Recipient (upon receiving key)
*
Signature of Issuer (upon key return)
Submit Log Entry
Submit Log Entry
Should be Empty: