UNIVERSITY OF SOUTHERN MAINE
FACILITIES MANAGEMENT
KEY RETURN FORM
Portland
Gorham
CAMPUS: DATE:
KEY(S) RETURNED BY:
KEY(S) BEING RETURNED:
Building Room #
Building Room #
Building Room #
Building Room #
Building Room #
Office Use Only
Key # ______________________ Hook # __________
Key # ______________________ Hook # __________
Key # ______________________ Hook # __________
Key # ______________________ Hook # __________
Key # ______________________ Hook # __________
Faculty / Staff Name Position Phone Number
Department Building E-mail Address
Leaving USM
Office Move
Position Change
Other
JUSTIFICATION: ADDITIONAL INFORMATION:
KEY(S) RECEIVED BY:
Facilities Management Representative Signature Date of Receipt
All University keys must be returned back to Facilities Management upon position change, office move, or vacation of position in order to
maintain accurate inventory. Failure to return keys to Facilities Management may result in significant re-keying charges to the responsible
party or department.