AZAFIS SERVICE REQUEST

1. Requestor Date

2. Requestor Name

3. Requestor Agency

4. Request Number

5. Requestor Title

6. Requestor Phone

7. Requestor Email

8. Requestor FAX

9. Agency Name & Address

10. New Access
(TOFI Required if Yes)

Yes No

11. Hardware Modification

Yes No

12. Network Modification

Yes No

13. Software Modification

Yes No

14. Cost Estimate

Yes No

15. Description of Requested AZAFIS Service (including requested completion date):

If service requested entails New Access, complete the attached Technical, Operational, Fiscal Impact (TOFI) Analyses document

16. TOFI Document Completed

Yes No

NOTE: If requested service modifies current network configuration, FAX (602-223-2978), email (mjohnson@azdps.gov), or mail diagram of current configuration and diagram of proposed configuration, including functional work flow. Detail of diagrams must be to port level. If this request requires network/site configuration changes, final approval of AZAFIS Service Request will not be granted until acceptable network/site configuration diagrams are received and approved by the State AZAFIS System Administrator.

17. Required?

Yes No

18. Date Network/Site Confiquration Diagrams Received by State AZAFIS System Administrator:

20. Comments:

21. Service Request Approved Disapproved by:
(DPS USE ONLY)

Date:

23. Assigned AZAFIS Project Manager:
(DPS USE ONLY)

24. Projected Completion Date:
(DPS USE ONLY)

25. Date Service Request Closed:
(DPS USE ONLY)