Ssn Exemption Request Form - University Of Nebraska, Kearney Page 5
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51. Complete the form online with the exception of the Department Head signature
box.
2. Print the form using the print function in your browser and then click the Finish
button.
3. Department Head signs the form and forwards to:
Deb Schroeder
Assistant Vice Chancellor for Information Technology Services
114 Otto Olsen
University of Nebraska Kearney
Kearney, NE 68849
Information Technology Services will review the form and forward it to the
Chancellor for approval.
Exemption Approved
Exemption Denied
Chancellor's Office Signature
__________________________________
Date Signed
__________________________________
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