INSTRUCTIONS for System Access/Change Application (PPS DS).

This document is a MS Word document. Please complete ENTIRE document by typing in your information.

TYPE OF REQUEST:Self Explanatory – Place cursor over box and double click.

DATE:Self Explanatory - YYYYMMMDD. Example: 1 August 2017 becomes 20170801.

PART I: To be complete by the Requester.

  1. NAME: Self Explanatory.
  2. EMPLOYEE ID: Self Explanatory.
  3. HOME DEPARTMENT NAME & CODE: Home Department - Department Name.
  4. EMAIL ADDRESS: Per UCD Directory
  5. TELEPHONE: Your work phone or your work cell phone; Per UCD Directory.
  6. JOB / WORKING TITLE: Title Code - Title Name / Working Title.
  7. CAMPUS UCD LOGIN (Kerberos) ID: Self Explanatory
  8. JUSTIFICATION FOR ACCESS: Please be specific in the justification for requesting access. If the requester is a Temporary Employee/Student, please provide the end date of their assignment in #21.
  9. USER SIGNATURE: the requester's signature
  10. DATE: Self-Explanatory.
  11. INFORMATION REQUESTED: Identify the department(s) or school(s)/division(s) you need access to. Also if access is limited to specific report(s), please specify report number(s). NOTE: If the Open Provision application is required, please type: "Require access to Open Provision". This should be approved by the MSO/CAO, Office Manager, or Financial/Fiscal Officer.
  12. TYPE OF DATA ACCESS REQUIRED: See Personally Identifiable Information (PII) are such: Birth Date, Sex Code, Ethnic ID, SSN, etc … If you are not certain, please see your CAO/MSO, Manager, or Supervisor.
  13. PII: See UCD PPM Section 320-20. Self-Explanatory. If your request does not require PII, put "NONE" or "N/A".
  14. UC CYBER SECURITY AWARENESS TRAINING: Self-Explanatory. Please attach Certificate of Training to request.
  15. Please describe how you will protect/secure the data: Self-Explanatory.
  16. Does your environment (computer, server, etc…) comply with UCD Cyber-Safety Policy? Self-Explanatory.
  17. Please provide your department Technical Support Contact information. Preferably, your department IT team name, email address, and phone as appropriate. Self-Explanatory.

PART II: ENDORSEMENT OF ACCESS BY USER SUPERVISOR OR SPONSOR:

20-28. Should be completed by the Requester’s Supervisor or Sponsor, NOT the PPS Officer/Coordinator. Self-Explanatory. NOTE: (21. Access Expiration Date) Appointment End Date or “INDEFINITE” for career staff/acad.

Submit completed application to your PPS Officer/Coordinator for their signature

PART III: ENDORSEMENT OF PPS OFFICER/COORDINATOR (See Footnote of request).

29-31. Should be completed by the PPS Officer/Coordinator and their signature. Self-Explanatory.

32-34. Should be completed if additional PPS Officer/Coordinator is necessary.

When complete, return request form and Cyber Training certificate only.

SYSTEMACCESS / CHANGE APPLICATION
PPS Decision Support (DS)
See Instructions on Page 1
TYPEOFREQUEST
INITIAL MODIFICATION RECERTIFICATION DEACTIVATION / DATE(YYYYMMMDD)
PARTI(TobecompletedbyRequestor)
1. NAME(Last, First,Middle Initial) / 2.EMPLOYEE ID
3.HOME DEPARTMENT CODE and NAME
4.EMAIL ADDRESS / 5.TELEPHONE
6.JOB / WORKING TITLE (TC –Title Name / Working Title) / 7.CAMPUS UCD LOGIN (Kerberos ID)
8.JUSTIFICATIONFORACCESS (Please be specific in describing access need and how data will be used. You may be contacted by a member of the authorization team for clarification.)
Access to the Payroll/Personnel System Data Warehouse or Decision Support is granted for the performance of your assigned duties ONLY. Misuse or abuse of computer access privileges are serious matters which may constitute violations of the federal and/or state criminal statues, as well as violations of the California Information Practices Act and the Family Rights and Privacy Act of 1974. Employees with access to personal and confidential records shall take all necessary precautions to assure proper safeguards are established and followed to prevent unauthorized access and to protect the confidentiality of employee records. Employees may not disclose personal or confidential information concerning individuals to unauthorized persons or entities as specified by Personnel Policies, other Campus Policies and Collective Bargaining Agreements. Violations of relevant policies and law could result in penalties such as suspension, termination, fines, imprisonment, or other criminal penalties for acts, which constitute crimes. See the following UCD and UC policies set forth in the UC Policies Applying to Campus Activities, Organizations, and Students (1994): UC Davis Policy and Procedure Manual Section 320-20 Privacy of and Access to Information, Section 320-21 Disclosure of Information from Student Records, Section 380-17 Improper Governmental Activities, Section 310-22 UC Davis Cyber-safety Program, and Section 310-75 Whole Disk Encryption
9.USERSIGNATURE / 10. DATE(YYYYMMDD)
11.INFORMATION REQUESTED (Identify information including divisions, departments, reports as needed.)
REQUEST ACCESS TO:
12.TYPEOF DATA ACCESSREQUIRED
Non-Personally Identifiable Information Only Personally Identifiable Information (PII)
13. PII (List all requested PII data elements)
14.UC CYBER SECURITY AWARENESS TRAINING (Attach copy of certification.)
IhavecompletedAnnualInformationAwarenessTraining.DATE(YYYYMMDD):
15.Please describe how you will protect/secure the data.
16. Does your environment comply with UCD Cyber-Safety Policy, please explain?
TECHNICAL SUPPORT CONTACT (Requestor’s department contact for coordinating resolution of any hardware/software issues.)
17. NAME(Last, First,Middle Initial) / 18.TELEPHONE
19.EMAIL ADDRESS
PARTII-ENDORSEMENTOFACCESSBYUSERSUPERVISOR ORSPONSOR
By signing this form, I accept responsibility for the permission/change to access the Payroll/Personnel System Data Warehouse or Decision Support for the individual identified above, and acknowledge that I am responsible for ensuring that such access is not misused. I also understand that it is my responsibility to take appropriate action to remove this person’s access if the individual’s responsibilities change, such that access to PPS Data Warehouse or Decision Support is no longer required for successful completion of duties of the position. NOTE: I ensure that our request for access to data outside of our department / division was approved by an authorized person from that school, division, unit, or department. (Please attach authorization.)
20.VERIFICATIONOFNEEDTOKNOW
Icertifythatthisuserrequiresaccessasrequested. / 21.ACCESSEXPIRATIONDATE (INDEFINITE or END DATE)
22.HOME DEPARTMENT NAME & CODE / 23.E-MAILADDRESS
24.TITLE (Working Title) / 25.TELEPHONE
26.AUTHORIZING AUTHORITY (Last, First,Middle Initial) / 27.AUTHORIZING AUTHORITY SIGNATURE / 28.DATE(YYYYMMDD)
PARTIII-ENDORSEMENTOFPPS OFFICER/COORDINATOR (See footnote).
29.SIGNATUREOFPPS OFFICER/COORDINATOR / 30.TELEPHONE / 31.DATE(YYYYMMDD)
32.ADDL SIGNATUREOFPPS OFFICER/COORDINATOR(if necessary) / 33.TELEPHONE / 34.DATE (YYYYMMDD)

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * INTERNAL USE ONLY * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

USERID

Access:

UNIVERSAL ACCESS / FUNCTIONAL UNIT(S) / DEPARTMENT(S) / ADDITIONAL RESTRICTIONS
ACCESS APPROVED/GRANTED /
DATE

Please return this application to: Scan and Email to PPS DS Form, 1 August 2017

Departments: Please have your PPS Officer/Coordinator ( sign Part VI before submitting request.

UCD Health Department/Clinic: Send your request to: PPS Officer/Coordinator, Account Payable, 4900 Broadway Building, Suite 2300, Sacramento, CA 95820.

SOM Department: Send your request to: SOM Dean’s Office, 2300 Stockton Blvd (Sherman Building), Suite 3900, Sacramento, CA 95817.