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IT Access Request Form

Poonam Garg has submitted a user access request form to her employer Valuefy Solutions to request a laptop for work. She is an intern product specialist in need of system access to efficiently work on projects, as her personal laptop has issues. Her manager Rasika Deo approved the request. The form details the user and access information, assets, terms and conditions governing appropriate use of company systems and data.

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172 views

IT Access Request Form

Poonam Garg has submitted a user access request form to her employer Valuefy Solutions to request a laptop for work. She is an intern product specialist in need of system access to efficiently work on projects, as her personal laptop has issues. Her manager Rasika Deo approved the request. The form details the user and access information, assets, terms and conditions governing appropriate use of company systems and data.

Uploaded by

CSK
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 4

VALUEFY IT Department Form Number:

VFY-IT-001
User Access Request Form

Section (A) User Information (Filled by the user)


Please complete this section with the your information:

Name (Last, First Mid) Employee Number # Network ID E-Mail Address


Poonam Garg VF367 [email protected]

Job Title Position Org. Code Organization Name


Product Specialist Intern
Company Branch Department Telephone Number

Valuefy Solutions LTD. Thane EAM +919785771625

Section (B) General Access Information


Please fill out the following access request basic information:
Request Date: Requester Type: Action Requested:

☐ Lock User
☐ Unlock User
☒ Valuefy Employee ☒ Create System User ☐ Other, Specify: ( )
☒ Contractor ☐ Change Permissions
☐ Other, Specify: ( ) ☐ Change Password

System (Please choose one only): Validity Period


From To

☐ PRD☐ DEV☐ QA/Training☐ IDES ☐ BI/BO ☐


   /    /         /    /     

Section (C) Access Areas


Sr. Training Required
Access Level *
No. Service
Local International AD Group
Administrator Manager User Yes No
service service name
1 Laptop ☐ ☐ ☒ ☐ ☒ ☐ ☐
2 Desktop ☐ ☐ ☐ ☐ ☐ ☐ ☐
3 Internet ☐ ☐ ☐ ☐
4 Email ☐ ☒ ☐ ☐ ☒ ☐ ☒
5 Auditor/Visito
r
☐ ☐ ☐
6 Telephone ☐ ☐ ☐ ☐ ☐ ☐ ☐

Reason for Access Business Justification

Page 1 of 4
VALUEFY IT Department Form Number:
VFY-IT-001
User Access Request Form

- To start working on the projects - BAs have client data on their machine & hence
efficiently. they have to have a Valuefy system.
- My personal laptop does not work
without power and it has some
issues with speaker and mike.

Page 2 of 4
VALUEFY IT Department Form Number:
VFY-IT-001
User Access Request Form

Section (E) Information Technology Assets (to be filed by IT Department)

Refer to Assets Document #:____________

Section (F) Approval


ID # VF320 Signature: Date:

   10 /08 /2021
    

Title: Business Analyst


Requester’s Direct Manager:
Organization: Valuefy Solutions Pvt
Name: Rasika Deo
Ltd

Section (G) Terms and conditions

● You may only access computing resources for which you have specific authorization and only in accordance
with authorization business need,
● Your password verifies your login identification (login ID) and is intended for your use alone. You are
responsible for keeping it confidential and for changing your password based on your company security
policy. If you suspect someone else knows your password, change it immediately.
● Intentional violation of this agreement may result in disciplinary action, legal action or both. You may be held
responsible for any willful and deliberate misuse, systems damage or security breach, that is traceable to your
assigned Login ID.
● I, the undersigned, hereby request access to the Internet through a site owned and operated by Valuefy. I
understand that Internet sites are monitored by Valuefy, and that the information transmitted and received
through its sites is not secure. I also understand that Valuefy has the right and obligation to maintain its
security and the confidentiality of information pertaining to its employees and the operation of its facilities. I
understand that, as a result, data transmitted and received through its Internet facilities will be reviewed from
time to time by IT security personnel at Valuefy. I therefore authorize Valuefy to review any data, including e-
mails, which I transmit through the Internet facilities of Valuefy.
● I also confirm that I am aware that the transmission or reception of materials with political or sexual content is
illegal in the Republic of India and against the rules and regulations of Valuefy. I therefore acknowledge that,
should I willfully transmit or receive any such materials, I may be subject to disciplinary action, including
termination as per the IT Act and being reported to Indian Government authorities.
● I agree that I will not use any Internet facility without following Valuefy procedures for accessing the Internet,
and I will immediately report any inadvertent access to illegal materials to the Information Technology
Department.

By signing this you agreed and understand all what has been mention in this document and agreed on the Valuefy
policies related to IT and over all culture

User Signature: Name: Request Date: 10/08/ 2021

Page 3 of 4
VALUEFY IT Department Form Number:
VFY-IT-001
User Access Request Form

Poonam Garg Training/Info. Received Date:

Page 4 of 4

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