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Building access card request form


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KBR TOWER

BUILDING ACCESS CARD REQUEST FORM

Date:


Addition Deletion Information Change

Employee Name:


Company:
Department:
Suite Number:
Phone Number:
24 Hour Access Authorized: Yes No
Tenant Representative Authorized Signature:
Print Tenant Representative Name:
Please be advised that in the event a card is lost, stolen or not returned by the cardholder, a $12 replacement fee will be assessed by building management to the tenant.

FOR OFFICE USE ONLY
EXTERNAL NUMBER:
INTERNAL NUMBER:


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