Person of Interest (POI) Role Sponsored Identity Request Form This form is for requesting a Harvard ID (HUID) number for a non-employee “Person of Interest” such as a contractor, consultant, vendor, tenant, security staff, or agency temporary worker. Note that not all persons who are issued a Harvard ID number are eligible for an ID Card. Important: All fields with an asterisk must be completed or this form will not be processed. The sponsored individual’s name and date of birth must match government-issued ID. Questions? Call 617.496.7827 or email [email protected] with subject “Sponsored Identity Request Form.” Individual Being Sponsored Last name* First name* Middle name* Start date* Date of birth* (MM/DD/YYYY) End date* (not more than 15 months from start date) Gender: Male Female Last 4 digits of Social Security number: Has this person been at Harvard before? Yes No Unknown Previous HUID, if known: Residential address Telephone number Email* Department School or business unit Role: Consultant Contractor Vendor Family Tenant Other (specify): Does this person need an ID card? Company name (if external) Yes No Security If yes, wording on card (max 15 characters): Sponsor (Administrator or Faculty Member) Information Last name* First name* Harvard ID (HUID)* Title Department School or business unit EmailPhone If this request was made by someone other than the sponsor, please provide their details. Last name First name Email Phone Acknowledgment & Signature By endorsing this individual for a sponsored identity, you are affirming that this person has a legitimate business, research, or educational reason to obtain an HUID. You also agree to take responsibility for the accuracy of the information provided, for keeping the information on this individual up to date, and promptly notifying ID Card Services when the individual’s affiliation with the University ends. Sponsor’s signature Print name Date Submitting this form from the sponsor or requestor’s harvard.edu email account does not require a signature. Email this form to [email protected] with subject “Sponsored Identity Request Form” or fax 617.496.8278