PRIVILEGED ACCESS REQUEST FORM

Reference IT
No :Department
IT20200817-0
Use this form to request access to information owned or administered by
JASAMERIN(M) SDN BHD when such access is required for a current investigation. Completing a request is not a
guarantee that privileged access will be granted.

Time :
Date :
Position:
Name:
Department Phone No :

SECTION A
Privileged Information (To be completed by the Staff)
category Type Applications Involved /BASSnet
[ ] Data Server
[ ] BASSnet 2.8
[ ] BASSnet HRM
[ ] Other
Information/Location :
Data
SIGN :
SECTION B

Receive Information (To be completed by the Staff after privileged successfully )

Time
Date Receive :
Receive:
SIGN: Remark :

SECTION C

Information Actions (To be completed by the IT Department)

Date Done : Time Done :

Action:

Status Measures: [ ] Unfinished [ ] In Action [ ] Completed

Next action:
(if not finished ranking
position)
Done By:

** Any questions please contact the Information Technology (IT) Ext: 1102 , Ext: 1154, Ext :1131