BSBK Relinquish Space Request

 

Full Name (First, Last)

 
 
 
 
 
 
 
 

Confirm if this space is vacated:

  • Fully Vacant of all DOE items
  • Cleared of all personal items
  • Cleared of all lab equipment
  • Cleared of all trash
 

Optional if unknown at this time.


Example: 10000 - 001

 

Not Required

Drop your files here