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Action Item Request / Project Issue Report / Scope Change Request

(see note at end of document)


Project:
Project Manager:
Prepared by:
Date:
Control No. Requested by Date requested/reported

Status Assigned to Date closed/resolved

Description of request/issue

Business benefit/anticipated result

Consequences if ignored

Project budget and schedule impacts

Alternatives

Recommended action or resolution

Sponsor approval to investigate (optional) (X)

Sponsor approval for resolution (X)


NOTE: This form can be adapted for reporting or opening items on: Action Item Request, Project Issue Report,
or Scope Change Request. Log the items or issues on a corresponding Action Item Log, Project Issues List, and
Scope Change Log, adapted from the accompanying Issues Log document.

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