A facility access request form asks for permission to use company premises outside normal arrangements, such as after hours, on weekends or holidays, at another office or plant, or in areas like the conference hall or warehouse. It lists the people, dates, areas and purpose, and is approved by the manager, facility owner and security.
After hours / Weekend / Holiday / Other site / Special area
1. Requester
Name
[Employee Name]
Employee ID
[Employee ID]
Designation
[Designation]
Department
[Department]
Mobile Number
[Mobile Number]
Supervising employee on site
[Employee Name]
2. Access Details
Date(s)
[DD/MM/YYYY] to [DD/MM/YYYY]
Time
[HH:MM] to [HH:MM]
Areas required
[Floor / Room / Warehouse / Training Hall]
Purpose
[Purpose]
3. People Entering
S. No.
Name
Employee / Vendor ID
Company / Department
Mobile Number
1
[Employee Name]
[Employee ID]
[Department]
[Mobile Number]
2
[Employee Name]
[Employee ID]
[Department]
[Mobile Number]
3
[Vendor Name]
[Vendor ID]
[Vendor Company]
[Mobile Number]
4
[Vendor Name]
[Vendor ID]
[Vendor Company]
[Mobile Number]
4. Services and Safety
Air-conditioning / power required
Lift operation required
Housekeeping required
Pantry / meals required
First-aid kit and emergency contacts available
Drop transport arranged for late-hour staff
PPE / work permit arranged (plant or maintenance work)
Consent and safety arrangements for women employees working late recorded
5. Approver Chain
Level
Approver
Name
Decision
Date
1
Reporting Manager
[Reporting Manager]
Approved / Rejected
[DD/MM/YYYY]
2
Facility / Admin Head
[Admin Name]
Approved / Rejected
[DD/MM/YYYY]
3
Security In-charge
[Security Officer]
Noted – guards briefed
[DD/MM/YYYY]
6. Requester Undertaking
I will ensure that only the persons listed above enter the facility, that they follow safety and security rules, and that the premises are left secure, with lights and equipment switched off, at the end of the approved time.
7. Security Log
Date
Entry Time
Exit Time
Persons
Guard Name
[DD/MM/YYYY]
[HH:MM]
[HH:MM]
[Count]
[Security Officer]
[DD/MM/YYYY]
[HH:MM]
[HH:MM]
[Count]
[Security Officer]
Requester [Employee Name] Date: [Date]
Approved by [Admin Name] Facility / Admin Head Date: [Date]
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Frequently asked questions
Who approves weekend or holiday office access?+
Usually the reporting manager approves the business need, the facility or admin head approves the services, and security arranges guarding and logs.
Is permission needed for women employees to work late?+
Many state Shops and Establishments rules set conditions, such as consent, transport and safety arrangements, for women working at night. Check the rules applicable to your state and premises.
Can vendors be included in a facility access request?+
Yes. List each vendor person with their ID and company, and name the employee who will supervise them.