FloridaA&MUnivERSITY

enterprise information technology

Production Change Request Form

Revision7

1. Requestor 2. Reference

Name
Phone
EIT Group:SecurityPeopleSoftNetworking
Req. Date JanFebMarAprMayJunJulAugSepOctNovDec200820092010 891011121234567:00153045ampm
month day year time / CR#
TMS:
iSRVCE
Other:

3. Brief Description of Change

4. Schedule and Resource Details

Date of Change
Begin: JanFebMarAprMayJunJulAugSepOctNovDec 200820092010 891011121234567:00153045ampm
End:JanFebMarAprMayJunJulAugSepOctNovDec 200820092010 891011121234567:00153045ampm
month day year time / Person Managing Change
Name:
Phone:

5. Reason for Implementing Change

6. Risk Analysis

Risk Type / Risk Level
Low / Medium / High
Complexity of Change
Number of Customers Affected
Recovery Difficulty
  1. Business Impact .

Check the appropriate box(es) below to indicate whether this change:

  1. Impacts students
/ f. Provides new Functionality
  1. Impacts faculty and staff members
/ g. Enhances existing functionality
  1. Impacts vendors
/ h. Corrects existing problem
  1. Impacts reporting requirements
/
  1. Impacts Disaster Recovery/Business
Continuity
  1. Is the result of changes in State or
Federal Laws or regulations / j. None of the above (explain below.)

If (i or j) is selected, please provide additional details:

______

______

______

  1. Financial Impact.
  2. What is the estimated internal effort required in executing this change? _____ (no. of hrs)
  3. What is the external dollar cost of adopting this change?
  4. What are the estimated recurring expenditures expected from adopting this change?
  5. What are the total annual revenues expected as a result of this change?
  6. Are there estimated savings from adopted this change? (If yes explain below) ___
  7. Are there any fiscal effects on State funding? (If yes explain below): Y/N ___
  8. Are there any fiscal effects on Federal funding? (If yes, explain below): Y/N ___

Notes:

7. Affected Systems

Hardware:
Software:
Network:

8. Production Change Task Details (Procedure used to execute change)

Task # / Date / Task Description / Resource
Name/Phone / Notification
Name/Phone
Start / End
1
2
3
4
5
6

9. User Acceptance Test Plan (Tests performed in UAT environment to validate change)

Task # / Date / Task Description / Resource
Name/Phone / Notification
Name/Phone
Start / End
1
2
3
4
5
6

10. Test Plan to Validate Changein Production (Procedure used to verify changewill occur correctly)

Task # / Date / Task Description / Resource
Name/Phone / Notification
Name/Phone
Start / End
1
2
3
4
5
6

11. Rollback Plan. (Procedure used to reverse change if it fails in production)

Task # / Date / Task Description / Resource
Name/Phone / Notification
Name/Phone
Start / End
1
2
3
4
5
6

12. Signoff

Section Director

Name______

Signature ______

User Acceptance Tester

EIT

Name______

Signature ______

Customer (FAMU User Community) has been notified. Name: ______

Security Officer

Name____Michael McAvoy___

Signature ______

Request made from Executive Manager without supporting documentation

Name of Manger:______

Department:______

Date of request: :

month day year time

Change Control Form

Revision7

EIT – 17D.001-01