Submit this form to the Systems Development Office.

Requester: _____________________________________ Date: _________________

Department or Office: ___________________________________________________

Campus Address: _________________________ Telephone: _____________________

On-line access to the Financial Records Systems is requested for the following accounts.

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

Other access requested (specify desired usage )

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

Signatures

Requester: ___________________________________________ Date: ______________

Dept. Head/Dean: _____________________________________ Date: _______________

Acctg./C&G Review: __________________________________ Date: ________________

Systems Review: ______________________________________ Date: _______________

Approved Comptroller: _________________________________ Date: _______________

SD030-10/96 (revised)