PARKING STAMP REQUEST The Letter Must Be Printed On

parking stamp request the letter must be printed on your department letterhead. the letter must be generated by your department head (inclu

PARKING STAMP REQUEST
The letter must be printed on your department letterhead.
The letter must be generated by your Department Head (include the
name, title and complete signature of the department head)
The letter must include the name, title, and signature of individual
authorized to pick up the stamps.
The letter must be dated for the day you plan to take it to the
parking office to purchase the stamps.
The letter must be an original print on letterhead (no copies.)
Bring letter to the Harvey 108 ID/Parking Office and remind them that
this purchase is at the patient/visitor rate and is authorized by
Randy Kemp.
TEMPLATE for letter:
Date: 00/00/00 (date of purchase at parking office)
To Whom It May Concern at the Parking Office,
We would like to purchase _____ parking stamps (sold in books of 10)
at the patient/visitor rate to provide to our research study
participants at study visits. Randy Kemp of the parking office has
authorized this purchase price.
The title of this research project is _______________ and the IRB # is
NA_000______________.
Please charge budget # _________________________ cost center
#______________for this purchase.
I understand that the person responsible for the safe keeping and
dispensing of the stamps will keep a log including the stamp book
number, the recipients’ subject number, and the date the ticket was
dispensed. This person will keep the stamps in a locked area for
safekeeping when not in use.
I also understand that the use of the stamps will be monitored by the
parking office. The stamps may not be used by faculty, staff or
students. If they are used inappropriately, the stamps will be revoked
and future purchase of the stamps by this group will not be allowed.
I authorize _____________________________ to pick up these parking
stamps on my behalf.
Thank you for your consideration,
________________________________________
Signature of Department Head
Department Head printed name
Department Head title
________________________________________
Signature of person authorized to pick up stamps
Authorized Person Printed Name
Authorized Person Title