First Name:
Last Name:
Job Title:
Department/Team:
Employee ID/Account ID:
Email:
Phone Number:
Manager/Supervisor Full Name:
What is the specific purpose of this data access request?
Describe the business need for this data.
Is this a one-time request or recurring access?
One-time request
Recurring
Frequency:
What is the expected duration of this access?
Start Date:
End Date:
Will the data be used for internal or external purposes?
Internal
External
Will the data be shared with third parties?
Provide details.
Is this request related to a specific project or initiative?
Project/initiative name:
Details of the project/initiative:
Specify the data source(s) required (e.g., database name, application name, file location).
Describe the specific data elements or fields required. Be as precise as possible.
What type of data is being requested?
What is the sensitivity level of the data?
What is the volume of data expected to be accessed? (e.g., number of records, size of file)
Are there any specific data filters or criteria required, and what are they? (e.g., date range, location, customer segment)
What format is the data required in?
What level of access is required?
What system or application will the data be accessed through?
What method of access is required?
Does the requester have the necessary technical skills to access and use the data?
What training or support is required?
What software or tools will be used to analyze or process the data?
What is the target environment for the data?
I confirm that I understand and will comply with the organization's data security and privacy policies.
I confirm that I will only use the data for the stated purpose.
Describe the measures that will be taken to protect the confidentiality and integrity of the data.
Will the data be stored or processed on personal devices?
Explain security measures.
Will the data be transferred across international borders?
Who is responsible for ensuring compliance with data retention policies?
Any other relevant information or comments.
Date of Request:
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Strengths:
Detailed Information Gathering:
Emphasis on Purpose and Justification:
Focus on Data Security and Compliance:
Clear Structure:
Manager Information:
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