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Network Deactivation Request Form

Network Deactivation Request Form

 

This form is to be completed by Supervisors or Managers when a member of their staff is no longer employed by the Division of Rehabilitation Services. Additionally, please complete this form if the employee transfers to DDS. The information contained in this form will be used by DoIT and AWARE Support staff only. Please complete the form in its entirety. Failure to do so may result in premature removal of employee files and data.

This applies to everyone working for DORS who previously had network access including but not limited to:

  • Permanent Employees
  • Contractual Employees
  • Volunteers
  • Interns 
Before completing this form you will need to gather some information from each DORS supplied Technology Equipment assigned to the individual. This includes, but not limited to:
  • Laptop
  • Docking Station
  • PC
  • Monitor(s)
  • Printer
  • Headset
  • Hotspot
  • Smartphone
For each piece of equipment you will need to enter the Barcode number and Service tag number (for Dell equipment only).

The barcode number is a six digit number and the barcode will state in red - Property of the State of MD MSDE.

The Service Tag Number (only pertains to Dell equipment) is a seven digit alphanumeric typically displayed on the back of the equipment. It will either say 'Service Tag:' or 'ST:'.

The equipment MUST be returned to DoIT staff at Argonne Drive for reimaging and re-distribution. No exceptions unless approved by the MIS Director.