:مقرلا ...
:خيراتلا / /
14 ـه
:تاقفرملا ...
ةيدوعسلا ةيبرعلا ةكلمملا ميلعتلا ةرازو فوجلا ةعماج
ةينقتلا عيراشملاو تامولعملا ةينقتل ةماعلا ةرادلإا
User Access Request Form
Access Request Number: _________________ Date: _____________________
Employee # Name:
Department / Section:
Position:
Company Name (for Third Parties):
Telephone:
Email ID:
Request Details
# Access / Authorization Information System Justification
Remote Access Required Yes No Justification:
End date:
Start date:
Duration
End time:
Start time:
Date:
Signature:
:مقرلا ...
:خيراتلا / /
14 ـه
:تاقفرملا ...
ةيدوعسلا ةيبرعلا ةكلمملا ميلعتلا ةرازو فوجلا ةعماج
ةينقتلا عيراشملاو تامولعملا ةينقتل ةماعلا ةرادلإا
Approvals Department Head / Manager
1. I confirm that the access request is justified and in line with the assigned responsibilities.
2. I understand that these access rights will not expose the organization to undue risk.
Comments:
Date:
Signature:
Yes No
Information System Owner Comments:
Date:
Signature:
Yes No IT Department Head Comments:
Date:
Signature:
Yes No
Actions taken by System Administrator Access Rights Granted:
User ID Created:
Other Actions:
Administrator name:
Date:
Signature:
