EMPLOYEE IDENTIFICATION ACCESS PASS APPLICATION PLEASE COMPLETE ONLINE AND PRINT, DO NOT FOLD WHEN COMPLETED – PHOTOCOPY/SCAN COPY OF THIS APPLICATION ARE NOT ACCEPTABLE JUNE 2018 EMPLOYEE INFORMATION SURNAME GIVEN NAMES MALE FEMALE DATE OF BIRTH (DD‐MMM‐YYYY) HOME ADDRESS UNIT # CITY PROVINCE POSTAL CODE HOME TELEPHONE CELL NUMBER HEIGHT CM WEIGHT KG HAIR COLOUR EYE COLOUR COMPLEXION EMAIL ADDRESS EMPLOYMENT INFORMATION EMPLOYER DEPARTMENT EMPLOYEE OCCUPATION BUSINESS TELEPHONE SIGNING AUTHORITY SIGNING AUTHORITY NAME DATE (DD‐MMM‐YYYY) SIGNATURE OF SIGNING AUTHORITY SIGNING AUTHORITY JOB TITLE SIGNING AUTHORITY EMAIL ADDRESS SIGNING AUTHORITY TELEPHONE PASS CONTROL USE ONLY PASS NUMBER EXPIRY KEYCARD NUMBER EXPIRY ACCESS CODE TRANSPORT CANADA SECURITY CLEARANCE INFORMATION SECURITY CLEARANCE FILE # LEVEL OF CLEARANCE DATE OF EXPIRY (DD‐MMM‐YYYY) TERMS AND CONDITIONS OF ISSUANCE 1. The pass/keycard issued to me is the property of the Greater Toronto Airports Authority. 2. I will immediately report the loss or theft of the pass/keycard to the Airport Authority Pass/Permit Office at 416.776.7277 or to the Security Operations Control Centre (SOCC) at 416.776.7381 3. The pass /keycard issued to me is valid only for those areas within the GTAA Administration Building to which I require access while on duty and in the functions related thereto. 4. I will not attempt to use the pass/keycard to enter an Airport Restricted Area. 5. I shall not loan or give my pass/keycard to another person. 6. I shall not have possession of, or use for any purpose, a pass/keycard that was not issued to me by a person having authority to do so. 7. I agree that the pass/keycard issued to me will be displayed visibly at all times while within GTAA facilities. 8. I will safeguard the pass/keycard at all times and will not willfully alter, tamper with, damage or duplicate the appearance of the pass/keycard. 9. I may be subject to an administrative fee for the loss/theft of my pass/keycard. 10. The pass/keycard issued to me, by or under the authority of my employer will be surrendered to my employer immediately upon termination of employment at this airport, or any other circumstances under which I was issued the pass; (maternity leave, disability, lay‐ off etc.) on demand or the breach of any condition contained herein. RECEIPT OF EMPLOYEE IDENTIFICATION I CERTIFY THAT: A) I have received the pass/keycard described above. B) I have read, understood and agree to comply with the Terms and Conditions of Issuance. EMPLOYEE SIGNATURE: DATE: A06
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EMPLOYEE IDENTIFICATION ACCESS PASS APPLICATION PLEASE COMPLETE ONLINE AND PRINT, DO NOT FOLD WHEN COMPLETED – PHOTOCOPY/SCAN COPY OF THIS APPLICATION ARE NOT ACCEPTABLE
JUNE 2018
EMPLOYEE INFORMATION SURNAME GIVEN NAMES MALE FEMALE DATE OF BIRTH (DD‐MMM‐YYYY)
HOME ADDRESS UNIT #
CITY PROVINCE POSTAL CODE HOME TELEPHONE CELL NUMBER
HEIGHT CM
WEIGHT KG
HAIR COLOUR EYE COLOUR COMPLEXION
EMAIL ADDRESS
EMPLOYMENT INFORMATION EMPLOYER DEPARTMENT
EMPLOYEE OCCUPATION BUSINESS TELEPHONE
SIGNING AUTHORITY SIGNING AUTHORITY NAME DATE (DD‐MMM‐YYYY) SIGNATURE OF SIGNING AUTHORITY
SIGNING AUTHORITY JOB TITLE
SIGNING AUTHORITY EMAIL ADDRESS SIGNING AUTHORITY TELEPHONE
PASS CONTROL USE ONLY PASS NUMBER EXPIRY KEYCARD NUMBER EXPIRY ACCESS CODE
TRANSPORT CANADA SECURITY CLEARANCE INFORMATION SECURITY CLEARANCE FILE # LEVEL OF CLEARANCE DATE OF EXPIRY (DD‐MMM‐YYYY)
TERMS AND CONDITIONS OF ISSUANCE 1. The pass/keycard issued to me is the property of the Greater Toronto Airports Authority.
2. I will immediately report the loss or theft of the pass/keycard to the Airport Authority Pass/Permit Office at 416.776.7277 or to the
Security Operations Control Centre (SOCC) at 416.776.7381
3. The pass /keycard issued to me is valid only for those areas within the GTAA Administration Building to which I require access while on
duty and in the functions related thereto.
4. I will not attempt to use the pass/keycard to enter an Airport Restricted Area.
5. I shall not loan or give my pass/keycard to another person.
6. I shall not have possession of, or use for any purpose, a pass/keycard that was not issued to me by a person having authority to do so.
7. I agree that the pass/keycard issued to me will be displayed visibly at all times while within GTAA facilities.
8. I will safeguard the pass/keycard at all times and will not willfully alter, tamper with, damage or duplicate the appearance of the
pass/keycard.
9. I may be subject to an administrative fee for the loss/theft of my pass/keycard.
10. The pass/keycard issued to me, by or under the authority of my employer will be surrendered to my employer immediately upon
termination of employment at this airport, or any other circumstances under which I was issued the pass; (maternity leave, disability, lay‐
off etc.) on demand or the breach of any condition contained herein.
RECEIPT OF EMPLOYEE IDENTIFICATION
I CERTIFY THAT: A) I have received the pass/keycard described above. B) I have read, understood and agree to comply with theTerms and Conditions of Issuance.
EMPLOYEE SIGNATURE: DATE:
A06
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