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Hire Date or Last day of work
*This will be listed on ID Badge
If you do not have a photo available, we will issue a non-photo ID Badge, or take a photo on your behalf.
Please check boxes for any additional access this employee needs Please note all Clerk personnel are given access to Independence Courthouse & 1840 Simon Kenton Way
Please note all Sheriff personnel are given access to Independence Courthouse & 1840 Simon Kenton Way
(Only for new employees)
(Only for employees needing a new ID Badge)
Badges for new Employees at Dispatch or Police may be delayed until we have photograph, birthday, and employee number to add to their ID Badge, since it is also used as an Employee ID. If new employee will need a temporary method to access the building until new badge is ready, click "yes".
What buildings does employee need access to? (Only for new/changed employees)
Add user for New/Changed Employee, Remove User for Departing Employee
Please list any other software or hardware needs not noted elsewhere
Submitter's name, in case there are follow-up questions
Email or Phone Number for follow-up questions
This field is not part of the form submission.
* indicates a required field