SOP 104.54-att-1: Request for Identification Card Form

Division:
Administrative & Finance
Effective Date:
July 1, 2003
Reference Code:
IVO15-0005
Topic Area:
104 Policy-HR Records/I.D./Criminal History
PowerDMS:
View on PowerDMS
Length:
255 words

Summary

This form is used to request Georgia Department of Corrections identification cards for employees, contractors, volunteers, and locators. The form requires the applicant's personal information, employee ID, job title, facility assignment, and appointing authority approval before an ID card can be issued. Personnel office staff use the form to document card issuance, type of card issued, expiration date, and the cardholder's acknowledgment of receipt.

Key Topics

  • identification card request
  • employee ID card
  • contractor ID
  • volunteer ID
  • locator card
  • ID issuance
  • ID card form
  • appointing authority approval
  • employee identification
  • cardholder receipt

Full Text

# GEORGIA DEPARTMENT OF CORRECTIONS

REQUEST FOR IDENTIFICATION CARD

SOP IVO15-0005
Attachment 1
Revised 7/01/03

|NAME SSN
PHOENIX EMPLOYEE ID/SCRIBE ID (REQUIRED) _________________________________________________________
EMPLOYEE JOB TITLE
FACILITY/UNIT OF ASSIGNMENT
DIVISION_________________________________________________________________________________________________
CONTRACTOR OR ORGANIZATION REPRESENTING|Col2|
|---|---|
|TYPE OF IDENTIFICATION CARD
(check applicable lines)

EMPLOYEE




LOCATOR




VOLUNTEER



CONTRACTOR

POSITION TITLE (division or section):
|DO YOU HAVE AN I.D. CARD TO TURN IN?

YES NO

LOST/STOLEN________________

CARD TYPE

|
|IDENTIFICATION CARD WILL NOT BE ISSUED IF EMPLOYEE/SCRIBE I.D. NUMBER AND/OR
APPOINTING AUTHORITY APPROVAL IS OMITTED|IDENTIFICATION CARD WILL NOT BE ISSUED IF EMPLOYEE/SCRIBE I.D. NUMBER AND/OR
APPOINTING AUTHORITY APPROVAL IS OMITTED|
|
APPOINTING AUTHORITY’S APPROVAL: _______________________________________________________

PRINT NAME:__________________________________________________________Date:____________________________

FACILITY/UNIT:TITLE:|
APPOINTING AUTHORITY’S APPROVAL: _______________________________________________________

PRINT NAME:__________________________________________________________Date:____________________________

FACILITY/UNIT:TITLE:|
|
(FOR PERSONNEL OFFICE USE ONLY)

IDENTIFICATION CARD ISSUANCE

CARD TYPE ISSUED (circle all types issued):

EMP LOC CON VOL


(Signature)

EXPIRATION DATE:





(Imaging Site)|
(FOR PERSONNEL OFFICE USE ONLY)

IDENTIFICATION CARD ISSUANCE

CARD TYPE ISSUED (circle all types issued):

EMP LOC CON VOL


(Signature)

EXPIRATION DATE:





(Imaging Site)|
|
IDENTIFICATION CARD ISSUANCE TO CARD HOLDER
CARD HOLDER ACKNOWLEDGES RECEIPT OF




(Signature) (Date)
(Check applicable line)
EMPLOYEE I.D.

VOLUNTEER I.D.

CONTRACTOR I.D.

LOCATOR CARD


|
IDENTIFICATION CARD ISSUANCE TO CARD HOLDER
CARD HOLDER ACKNOWLEDGES RECEIPT OF




(Signature) (Date)
(Check applicable line)
EMPLOYEE I.D.

VOLUNTEER I.D.

CONTRACTOR I.D.

LOCATOR CARD


|

Retention Schedule: Retain permanently in local personnel file (official personnel file if made in CPA); copy retained for two (2) years at imaging
site for any employee from a non-imaging site.

Attachments (3)

  1. Request for Identification Card Form (255 words)
  2. Report for Missing Identification Card Form (60 words)
  3. Notice of Discontinuation Form (138 words)
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