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Change Control Sheet: Change Request Impact Analysis

This document is a change request impact analysis form used by Avery Dennison and Siemens. It contains sections for requesting a change, evaluating its impacts and risks, making recommendations, and obtaining approvals. The requester provides details of the requested change. Then Siemens evaluates associated impacts, risks, and customer requirements. Siemens recommends an approach, assumptions, costs, and timeline. Finally, Avery can accept, reject, or defer the change request.

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M Baskar
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152 views

Change Control Sheet: Change Request Impact Analysis

This document is a change request impact analysis form used by Avery Dennison and Siemens. It contains sections for requesting a change, evaluating its impacts and risks, making recommendations, and obtaining approvals. The requester provides details of the requested change. Then Siemens evaluates associated impacts, risks, and customer requirements. Siemens recommends an approach, assumptions, costs, and timeline. Finally, Avery can accept, reject, or defer the change request.

Uploaded by

M Baskar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Change Request Impact Analysis

Avery Dennison – PMO

Change Control Sheet


Project Title: Siemens WO Number:
Siemens Project Manager:

CHANGE REQUEST – To be completed by requester


Requester: Date of request: Referenced attachments
(if applicable, imbed files using MSWord
menu item Insert/Object/Create From File)

Nature of change (e.g., schedule change, scope change, resource request):

Description of change:

Requested date to implement change:

397810051.doc
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Change Request Impact Analysis
Avery Dennison – PMO

CHANGE EVALUATION – To be completed by Siemens PMO


Change request no:
Impacts/conflicts associated with implementing change:

Associated risks:

Pending customer requirements/inputs:

RECOMMENDATIONS – To be completed by Siemens PMO


Proposed approach to change:

Assumptions and constraints:

Cost to implement change: Timeline to implement change (including impacts to existing


timeline to accommodate change):

Name of evaluator: Date evaluated:

CHANGE APPROVAL – To be completed by Avery


Accepted Rejected Deferred Name Signature Date

Comments

397810051.doc
Page 2 of 3
Change Request Impact Analysis
Avery Dennison – PMO

When to use this form:


 Please complete and submit this form to the Avery PMO, when requesting a project change for any active
project not yet in production
 For any change that materially changes the intent or direction of a project, do not use this form; instead,
please submit a revised Avery Solutions Questionnaire to the Avery PMO

What is a project change?


 Any change to a deliverable date once the project schedule has been published
o This includes putting specific deliverables on hold, as well as later taking them off of hold
 Any change (increase or decrease) to project scope or quality
 Any change in project resource requirements
 Cancellation of a project anytime after its WO is approved
o This includes cancelling remaining deliverables after a project has been partially implemented
 Any material change to a server in-scope for an active project

Process flow:

397810051.doc
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