ID Access: Deactivation

The ID Access office must be notified immediately when a badge holder's employment has been terminated. Please use this form for all termination notifications and badge deactivation requests.

Deactivation Type:

Employee Termination
Other Badge Deactivation

Company Information:

Employer Company Name
Employer Contact Name
Employer Contact Job Title
Employer Contact Phone	( ) -
Employer Contact E-mail

Employee Information:

LastName , First MI

Employee Job Title
POS Badge Employee# (if available)
Additional Comments:

Badge Possession Information:

Employer DOES NOT HAVE physical custody of this badge
Employer DOES HAVE physical custody of this badge

All information submitted through this notification request form is subject to verification by the ID Access office with the company requesting the badge deactivation.