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Accounting |Forms | Network System Access Form

Forms: Network Security System User Information



See instructions

* User must complete these items.

  1. Type of Request: *
      Add
      Change
      Delete

  2. Access Required: *
      Cent Connection (required for Procurement Card management)
      OSC Connection (Accounting and Purchasing personnel only)

  3. Technology Coordinator: *

  4. LAST NAME: (20 char. alpha)*

  5. FIRST NAME: (16 char. alpha)*

  6. MIDDLE INITIAL: (1 char. alpha)

  7. TITLE: (30 char. alpha)*

  8. BUILDING: (30 char. alpha)*

  9. ROOM: (6 char. alpha/numeric)*

  10. PHONE: (10 char. numeric)*

  11. E-MAIL ADDRESS: (complete Internet address)*

  12. DEPARTMENT: (30 char. alpha/numeric)*

  13. JOB FUNCTION: (Assigned by Security Administrator)

  14. NEW IP Address *     OLD IP Address (if applicable)


  15. ACCOUNTS FOR ACCESS: *
      State:       
        Enter your account number or numbers.

      IFR:       

  16. SUPERVISOR'S LAST NAME: (20 char. alpha)*

  17. SUPERVISOR's FIRST NAME: (16 char. alpha)*

  18. SUPERVISOR'S PHONE: (10 char. numeric)*

  19. EFFECTIVE DATE: (12 char. numeric)*

  20. COMMENTS: If this is a CHANGE request, state which fields contain new data:





   


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