Personal Technology Responsibility Form

Personal Technology Responsibility Form [1]

Purpose

To accept individual responsibilities associated with using university-provided personal technology and telecommunications equipment and services or being reimbursed for wireless telecommunications services.
This form must be signed by the recipient prior to obtaining the approved equipment and/or service. Note: Regents of the University use the Personal Technology Regent Responsibility (PTR) form instead of this form.
For additional guidance see the Finance Procedural Statement Personal Technology and Telecommunications [2].

Note

When the form has been successfully submitted, you will receive an email confirmation that you can share as appropriate.

Organizational Unit Name: *

Recipient First Name: *

Recipient Last Name: *

Recipient Email Address *

Recipient Employee ID (six digit): *

Each of the following responsibility statements must be checked in order to certify the recipient's agreement and submit the form.

Individual Responsibility 1 *

I must not use university-provided personal technology/telecommunications equipment while driving in states where such use is prohibited by law, or in medical or other facilities where such use is banned. I must use hands-free technology for telecommunications while driving in states where this is required by law.

Individual Responsibility 2 *

I will not loan university-provided personal technology and/or telecommunications equipment to anyone other than another University of Colorado employee or affiliate fiscal staff. I remain responsible for all use of my assigned equipment.

Individual Responsibility 3 *

Upon separation from university service, I must return university-provided personal technology and/or telecommunications equipment promptly to my organizational unit.

Individual Responsibility 4 *

If I incur personal charges on university-provided personal technology and/or telecommunications equipment, I must provide timely reimbursement to the University for those charges.

Individual Responsibility 5 *

I should refrain from discussing university information considered to be confidential or proprietary (e.g., customer/personal account information, PIN/credit card numbers) while using university-provided personal technology and/or telecommunications equipment. In the rare instances it is necessary to have such discussions, I should ensure that I complied with the appropriate university policies on confidentiality.

Individual Responsibility 6 *

If I incur activity that may be questionable upon public scrutiny or that otherwise has an appearance of impropriety, I will document the manner in which the activity was official university business on the organizational unit's copy of the detailed telephone bill.

Individual Responsibility 7 *

I must immediately report any theft or loss of university-provided personal technology and/or telecommunications equipment to my organizational unit.

Individual Responsibility 8 *

Data on university-provided personal technology and/or telecommunications equipment are considered public records. Detailed telephone bills (e.g., activity log for each telephone) are also public records, maintained in accordance with university retention policies. Data retained (saved) on the device itself are public records. I may request a copy of the detailed telephone bill for my personal records.

Certification

By clicking "Submit" below, I acknowledge that I have reviewed the University's guidelines and requirements for Personal Technology and Telecommunications. I further certify that I understand, and promise to abide by, the responsibility statements listed above.