SOP 109.01-att-3: Sample Request For Identification Card
Summary
Key Topics
- identification card request
- employee ID
- volunteer ID
- contractor ID
- locator card
- ID card issuance
- appointing authority approval
- personnel office
- GDC identification
- card types
Full Text
SOP 109.01
Attachment 3
6/30/20
|GEORGIA DEPARTMENT OF CORRECTIONS SAMPLE REQUEST FOR IDENTIFICATION CARD|Col2|
|---|---|
|
NAME
EMPLOYEE ID/SCRIBE ID (REQUIRED)
EMPLOYEE JOB TITLE
FACILITY/UNIT OF ASSIGNMENT
DIVISION
CONTRACTOR OR ORGANIZATION REPRESENTING
|
NAME
EMPLOYEE ID/SCRIBE ID (REQUIRED)
EMPLOYEE JOB TITLE
FACILITY/UNIT OF ASSIGNMENT
DIVISION
CONTRACTOR OR ORGANIZATION REPRESENTING
|
|
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/DESIGNEE
APPROVAL:
PRINT NAME:
Date:
FACILITY/UNIT:
TITLE:
|
APPOINTING AUTHORITY/DESIGNEE
APPROVAL:
PRINT NAME:
Date:
FACILITY/UNIT:
TITLE:
|
|(FOR PERSONNEL OFFICE USE ONLY)
IDENTIFICATION CARD ISSUANCE
CARD TYPE ISSUED (circle all types issued):
EXPIRATION DATE:
EMP
LOC
CON
VOL
(Signature)
(Imaging Site)
|(FOR PERSONNEL OFFICE USE ONLY)
IDENTIFICATION CARD ISSUANCE
CARD TYPE ISSUED (circle all types issued):
EXPIRATION DATE:
EMP
LOC
CON
VOL
(Signature)
(Imaging Site)
|
|IDENTIFICATION CARD ISSUANCE TO CARD HOLDER
CARD HOLDER ACKNOWLEDGES RECEIPT OF
(Check applicable line)
EMPLOYEE I.D.
VOLUNTEER I.D.
CONTRACTOR I.D.
LOCATOR CARD
(Signature)
(Date)
|IDENTIFICATION CARD ISSUANCE TO CARD HOLDER
CARD HOLDER ACKNOWLEDGES RECEIPT OF
(Check applicable line)
EMPLOYEE I.D.
VOLUNTEER I.D.
CONTRACTOR I.D.
LOCATOR CARD
(Signature)
(Date)
|
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.