CITS Services & Equipment Request

INCOMPLETE INFORMATION WILL NOT BE PROCESSED

To be filled by Staff Member:

ID NO. INDEX NO. DATE:

LAST NAME (NOM)

FIRST NAME (Prénom)

International Staff National Staff Military UNV Civpol

Region: __________________________ Unit: _______________________________

Section: _________________________ Extension: _______________________________

Request for: E-mail Network Pin Code  Others............

Previous Mission: ____________________________________________________

Previous E-mail: ___________________________________________________
Request for Equipment:
Description of Requested Equipment/Services Qty Remarks
1
2
3
4
5

Justification for Equipment: ____________________________________________________________________

I hereby assume full responsibility for the one time issuance of a UN cellular telephone/VHF radio to me. In the case of theft, I agree to provide a police report in
order to substantiate replacement of same. In the case of loss I agree to replace the telephone to at least a similar grade and brand of the instrument that is issued to
me and will absorb all related charges for its replacement.

I hereby assume full responsibility for the payment of charges deriving from all personal or unofficial calls made from the telephone extension which will be
assigned to me. In this connection, I am aware that (1) Using a UN telephone for personal calls is a privilege and will be removed if misused, and (2) Using the
UN network for private calls may mean that official calls are delayed and the system overloaded, hence private calls should be short duration and placed, if
possible, during off-peak hours.

Staff Member’s Signature: ___________________________________________________________

Section Chief’s Name and Signature: __________________________________________________

CITS Section Chief Name and Signature: _______________________________________________

For CITS use: (Please attach handover/issue voucher(s) to this form)

Date Received: ____________________________

Network Logon Name: ______________________

Lotus Notes Account: _______________________

Extension No. Assigned: _____________________ Copy of ID Card

CILCODE: _______________________________
Required if e-mail account requested

Date Processed: ____________________________

Telephone Directory Updated: _________________
________________________________________________________________________________
Please note that processing of ALL CITS Service Requests will take a Minimum of 48Hours.