IT Change Request Form

DSS/IT/FO/11 (Rev 1)

This form is for:

 Request a new or modification (changes) or deletion of SAP program application, infrastructure and operation
 Please complete to fill in the form and submitted back to IT Department.

1.) SUBMITTER - GENERAL INFORMATION

CR#
Type of CR Enhancement Defect
Project/Program/Initiative
Submitter Name
Brief Description of Request
Date Submitted
Date Required
Priority High Mandatory
Reason for Change
Business Impact if it is not
done
Comments
Attachments or References Yes No
Link:
Approval Signature Date Signed

2.) PROJECT MANAGER - INITIAL ANALYSIS

Hour Impact [#hrs]
Duration Impact [#dys]
Schedule Impact [WBS]
Cost Impact [Cost]
Comments
Recommendations
Approval Signature Date Signed

3.) CHANGE CONTROL BOARD – DECISION

Decision Approved Approved Rejected More Info
with Conditions
Decision Date
Decision Explanation
Conditions
Approval Signature Date Signed

UP Template Version: 11/30/06 Page 1 of 1

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