Remote Access Request
General Information:
Date of Request
Project Name
Function / Cell
Requestor Details:
Contact Person / Domain ID Contact No Email Location
Function Head Contact No Email Location
Change Request Definition
Description – Describe the proposed change.
Justification – Justify why the proposed changes should be implemented.
Impact Description – Describe the impact.
Request Server Detail:
Server Name Access Type Duration (min 4 hrs to 1 day) Location
Change Request by FH Approval:
FH Manager Name Title Approval / Reject
Recommendation – State the rationale for recommendation.
ITSSG - Data Center Support - HOV Services Version – 1.0 1 Remote Access Request
General Information:
Date of Request
IT Head Name Title Approval / Reject
Special Instructions – Provide any additional information regarding the final recommendation.
ITSSG - Data Center Support - HOV Services Version – 1.0 2