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When the employee separates from the University or transfers, this form should be completed and forwarded with the employees transfer or termination PAF. ___________________ _____________________________________________________ ____________________________________ EMPLID NAME (last, first middle initial) HOME DEPARTMENT University Property Issued to Employee Date IssuedDate ReturnedDescription of ItemKeys/Key Card (office, building other)University ID ( returned for separations only)Department/Division IDParking Permit (returned to dept or to Parking for separations only)Purchasing Card Travel Card University Club CardUniformTools/Equipment (please see attached list for specific items)Other (please list):  To be Processed at Separation or Transfer Date CompletedDescription of ItemPAFCampus Change of Address Form (for transfers)Forwarding Address for W2 and Removal of Address Restriction (for separations)Hourly Timesheet or Salaried Absences Submitted in Time & LaborSet up Out of Office Email Message (for separations)Voice Mail Access and Message ChangedRemove Name from Department Webpages/DirectoriesClean out Desk/LockerAny Outstanding Fees/Fines to be PaidSet Up Exit Interview with HRS if Requested by EmployeeEnsure removal of university data from personal devices (employee and University owned)  Access Issued to Employee Date RequestedDate Shut OffDescription of ItemComputer Account (email)WATS Access NumberSecurity System Access Other (please list)PS Access ( HR, Grants, APPO, ARBI, WebApps, etc.)Signature Authority (WebApps PS Authorization) Authorization to Access Accounts I authorize a representative from the department of __________________________________________________ to access my email account and/or other electronic files that may have been created or used by me during my employment in this department. __________ (employee initials) This is to confirm your last working date with this department will be _____________________. 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