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SSC-IT-DeS - Change Request Form v3

This document is an IT change request form used to request changes to existing IT systems and applications. The form collects information about the requested change such as the application, description, users impacted, and an assessment of costs and benefits. It requires approval from the department head, division head, and design implementation committee. If approved, the IT team will provide an impact analysis, development timeline, and complexity assessment. The final section documents approval from a change advisory board meeting.

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210 views4 pages

SSC-IT-DeS - Change Request Form v3

This document is an IT change request form used to request changes to existing IT systems and applications. The form collects information about the requested change such as the application, description, users impacted, and an assessment of costs and benefits. It requires approval from the department head, division head, and design implementation committee. If approved, the IT team will provide an impact analysis, development timeline, and complexity assessment. The final section documents approval from a change advisory board meeting.

Uploaded by

Hard Purnama
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
You are on page 1/ 4

IT CHANGE REQUEST (CR) FORM

Ref. barcode no:


(Please stick IT request barcode into this
field)
A. Change Request Information (this section is filled up by requestor & approved by Dept Head & EIC)
Date Raised (dd-mm-yyyy)
Service Desk ticket No (to be
filled up by SSC IT)

Level of Urgency

High

Medium

Low

Justification of your urgency


level:
Application:
(e.g:SAP, Magic, WMoS, WES, others)

Description of request:
(to be filled up by initiator)

Who will use it?


(to be filled up by initiator)
Usage frequency:
(to be filled up by initiator
Current implication
(to be filled up by initiator)
Description of cost - benefit (point 1 to 6 below): (to be filled up by initiator, can be filled more
than one point and must be converted to amount/Rupiah)
1. Processing time consumed
(related to time reduction of
process)
2. Increase of capacity
(related to production
capacity)
3. Cost of not doing
(related to cost which may
exist if not doing the CR)
4. Increase of sales profit
(related to sales profit)

5. Decrease of lost sales


(related to probability of
lost sales reduction)
6. Others
(other benefit)

File Name: 278531483.doc


Version Date: 7 February 2014
Page 1 of 4

IT CHANGE REQUEST (CR) FORM


Change Request Raised By (Key User) :
User NPK:
User Name:
Dept/BU/AFCO:

User Phone / HP:


User Email:
User Signature

Approval by Dept Head, EIC & DIC :


Dept Head
Approval

Div Head / EIC


Approval

DIC Approval
(More Than 100 ManDays)

Approved (Yes/No):
..// 20..

..// 20..

..// 20..

Signature & Name :

**** End of Section to be filled up by Requestor / Business Unit ****


**** The following Section is to be filled up by AOP BPM and SSC IT Team ****
B. Business Process Management (BPM) Approval
BPM
BPM Head
Approved (Yes/No):
.// 20..
.// 20..
Signature & Name:

(
)
High Level Impact
Analysis (for
approved CR) or
Workaround (for
Rejected CR)

File Name: 278531483.doc


Version Date: 7 February 2014
Page 2 of 4

(
)

IT CHANGE REQUEST (CR) FORM

C. The following Section is to be filled up by SSC IT Application Team


SSC IT Application Team
(e.g. SAP SD, non-SAP etc)
Name of Assigned SSC IT
Application Team
High Level Functional Assessment :
Development Complexity (e.g.
Low, Medium, High or Very High)
Development Type (e.g.
Enhancement, Report, Interface etc)
Estimated Development Time Line
(based on 1FTE equivalency)
.// 20.. until .// 20..
Detail Impact Analysis
(Impact analysis to other functions
and existing configuration & design,
whether regression testing/cross
function testing is required)
SSC IT Apps Lead

SSC IT Tower Lead

SSC Lead

Approved (Yes/No):
.// 20..

.// 20..

.// 20..

(..
.)

(
.)

(.
.)

Signature & Name:

**** End of Section to be filled up by SSC Team ****


D. The Following Section is to be filled up during CAB Meeting
Meeting Date :
.// 20..
Approved CR Delivery Date:

Approved
(Yes/No):
.// 20.. until .// 20..

Approved CR Urgency

(High, Medium or Low)


Meeting Attendance (CAB
Member Name)

1) ..

2) ..

3)

4)

Note:
1. If you are user (Business Unit / AFCO), please only fill-up section A. Do not
fill-up the other section.
2. BPO, BPM and BPS are located in AOP Head Office.
3. Please put this IT change request form into drop box in HR Local Support in
your area. Form will be sent to AOP Head Office by Document Messenger
everyday. If you need assistance, please call SSC Service Desk call center
File Name: 278531483.doc
Version Date: 7 February 2014
Page 3 of 4

IT CHANGE REQUEST (CR) FORM


from your office phone at <VoIP Code at your location>-8-88-1188 and
press 1 (IT support).
4. Please also note down your reference barcode number above (top right side)
for your reference when you call SSC Service Desk.
5. User / Requestor only need to print out the first page of this form and submit
it to SSC IT. SSC IT Apps team will print the second page and provide the
required information.
Penjelasan Cost Benefit:
1. Dengan adanya Change request ini maka process yang saat ini di lakukan
oleh user akan dapat di kerjakan lebih cepat dan efisien, dengan demikian
waktu yang di butuhkan lebih sediit, CR Initiator harus dapat menghitung
saving time yang ada dan dikalikan dengan rate time process(labour
cost/electrical cost/FOH cost, dll). Dengan demikian Process Time Consume
Before dan after secara amount dapat di hitung serta Saving Cost yang
terjadi.
2. Dengan adanya Change request ini maka akan dapat meningkatkan
kapasitas produksi yang ada saat ini. CR Initiator harus dapat menghitung
kapasitas sebelum adanya perubahan di system dan setelah adanya
perubahan di system dalam Amount/Rupiah.
3. Dengan adanya Change request ini maka secara Business akan dapat
menghindari/menghilangkan cost yang ada/kemungkinan timbul. CR Initiator
harus dapat menghitung berapa Cost yag saat ini ada/yang akan timbul jika
fiture/perubahan tersebut tidak di sediakan/lakukan pada system yang saat
ini ada.
4. Dengan adanya Change request ini maka secara business akan dapat
mengingkatkan sales dan Profit perusahaan. CR Initiator harus dapat
menghitung berapa peningkatan Sales & Profit jika perubahan pada system
tersebut di lakukan.
5. Dengan adanya Change reques ini maka perusahaan dapat menghindari
kerugian lebih besar lagi di karenakan lost sales yang terjadi. CR Initiator
harus dapat menghitung berapa kerugian yang dapat di hilangkan/di hindari
jika perubahan ini di lakukan pada system yang ada pada saat ini.
6. Jika ada suatu Cost & Benafit yang tidak ada korelasi dengan 5 point di atas,
maka User dapat mengisinya pada point No.6. Termasuk penjelasan
tambahan mengenai cost & Benafit yang telah di isi pada 5 point di atas.

File Name: 278531483.doc


Version Date: 7 February 2014
Page 4 of 4

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