University of Chicago
Access to Confidential Information Authorization Form

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1. Your login ID(s)/password(s) are unique to you as a user of one or more of the following systems:
  Financial Accounting System (FAS)
  Accounts Payable System (APS)
  Real Estate Office System (REO)
  Payroll /Personnel System (DBCOAS)
  Your login ID(s)/password(s) must be kept confidential. Your login ID(s)/password(s) replace your handwritten signature and are legally equal to a handwritten signature.
2. Your login ID(s)/password(s) are necessary for you to perform your job, so you must memorize them and store any written login ID(s)/password(s) in a secure place.
3. If you suspect that someone else is using your login ID(s)/password(s), or if your password card has been lost or stolen, you must immediately notify your supervisor and request a replacement.
4. If you undergo a status change of any kind (job description, job title, name, promotion, resignation/termination), remind your supervisor to inform the appropriate central office(s) so that the information can be updated.

Request to Access Confidential Information

It is requested that (name)                                                                  (SSN)                            

be given access to the University's (system name, listed in #1)                                                          

for the following units (list relevant department/unit name and code):
                                                                                                                                   

                                                                                                                                   

Employee Statement

I understand the University's policy on the necessity for security of computer login ID(s)/password(s). I have read and understand the four (4) points listed above and will handle my login ID(s)/password(s) as stated.

I also understand the University's policy on maintaining the confidentiality of information. I have read and understand the Employee Manual and Personnel Policy #U601, regarding Treatment of Confidential Information. I understand that all of these policies apply to me and that my failure to observe these policies may result in disciplinary action, including but not limited to, discharge.

Finally, I understand that a signed copy of this form, Access to Confidential Information Authorization Form, will be placed in my personnel file.

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 Employee Signature

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 Supervisor Signature

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URHM Signature (if applicable)

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Comptroller Signature (if applicable)

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Provost Signature (if applicable)