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IT080 Work Request V9

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IT Work Request

Request Number

I. To Be Completed by Business Unit


Business Unit Name Department Name

Requestor Name Requestor Signature

Desired Completion Date Date of Request

Type of Service Requested PRMS


PC Hardware or Software
Network Hardware or Software
Other (Specify Below)

Summary Description of Service Requested (Attach Details)

Potential Benefits and Cost Savings

Effect Upon Internal Security, if any

Business Unit Department Head Signature Business Unit IT Coordinator Signature

Business Unit Controller Signature

Note: Signatures in Section I serve as approval for IT analysis. Final approval for the project is given after estimates are received.

IT080 Work Request V9.pdf 1 Date of Last Change: 3/18/2005 2:56:00pm


IT Work Request

II To Be Completed by Corporate IT Department - Analysis Results


Estimated
Estimated IT Hours Hardware/Software Costs Estimated Start Date Estimated Completion Date

Impact on IT Resources

Alternatives Considered

Recommended Action

Impact on IT Security

III Approval to Proceed

Corporate IT Director (Signature) Date

LSB Upper Management Date

IT080 Work Request V9.pdf 2 Date of Last Change: 3/18/2005 2:56:00pm

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