DIVISION: INFORMATION COMMUNICATION TECHNOLOGY (ICT)

TITLE: REQUEST FORM FOR IPMS USER ACCOUNT CHANGES

DOCUMENT NO: ICT.FM.04 REVISION NO: 00 EFFECTIVE DATE: 01.04.2017

PLEASE TICK  THE APPROPRIATE BOX

Password reset Migration Request Deletion of Application

Temporary Login Details Company Name Update

 The form should be filled by the director of the company.

 A copy of ID/Passport for the director should be certified and attached to this form.

COMPANY
NAME:
(Provide company name in full)
COMPANY
DIRECTOR:
(Provide names in full)
ID NUMBER /
E-MAIL:
PASSPORT NO:

CONTACTS: (Mobile): (Tel):

APPLICATION
NO:
(If it is deletion of an application, provide the Application number)

I declare that the above information is true to the best of my knowledge and I understand that any legal action
shall be taken towards me if any information should be found not true as per the PPRA contractor code of
conduct.

SIGNATURE: DATE: ___ / ____ / ________

FOR PPADB OFFICIAL USE ONLY.

APPROVED BY: DATE: ___ / ____ / _______
(Print name & signature)
ACTION
ADMINISTRATOR:
DATE: ___ / ____ / _______
SIGNATURE:

Further information, please contact: Tel: 3602098 (Service Desk) Fax: 3906822

E-mail: servicedesk@ppadb.co.bw