DUO Security Hardware Token Sign-out Sheet
By submitting below, I acknowledge the following:
- Duo Security hardware tokens are used for employees to authenticate to the two-factor system for VPN access when no other methods are viable.
- Each hardware token is a controlled device. Employees must secure them in the same manner as they would a state-owned key.
Lost, stolen, damaged or missing tokens must be
reported by calling the EITS Helpdesk at (775) 684-4333 and you must also inform NHP
R&P via your chain of command.
- Upon termination of my VPN Account, I will return the hardware token to my Regional Administrative Lieutenant. Failure to do so may result in criminal or civil action against me.
- Cost for replacement tokens will be charged to my agency or sponsoring agency (if a contractor entity).
- By submitting below, I acknowledge receipt of one (1) Duo hardware token, DSEC # as indicated on the DSEC# line below.
- Make sure the form is filled out 100% and all information is accurate.
DSEC No.:
Name (First and Last):
Contact Phone No.:
Email Address:
Desktop Login Username (nvdps\xxxx):
Sponsoring Agency Name:
Region:
Which phone do you want to use for DUO Authentication?
Phone Used For DUO: Device Phone No.:
Phone Operating System (i.e., Android, iOS, etc.):
What is your State MDC tablet ID number?
MDC Tablet ID No. (Example: 350126):
By providing your employee ID number below, you acknowledge/verify the information above is correct:
State Employee ID No.: