Data Access Request Form

I. Requester Information

First Name:

Last Name:


Job Title:

Department/Team:


Employee ID/Account ID:

Email:


Phone Number:

Manager/Supervisor Full Name:

II. Purpose of Access

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?


What is the expected duration of this access?


Start Date:

End Date:

Will the data be used for internal or external purposes?

Will the data be shared with third parties?

Is this request related to a specific project or initiative?

III. Data Details

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?

IV. Technical Requirements

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 software or tools will be used to analyze or process the data?

What is the target environment for the data?

V. Security and Compliance

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?

VI. Additional Information

Any other relevant information or comments.

Date of Request:


Form Template Instructions

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Strengths:

Detailed Information Gathering:

  • The form thoroughly covers all essential aspects of a data access request, including requester details, purpose, data specifications, technical requirements, and security considerations.
  • This level of detail helps data owners and IT teams understand the context and requirements of the request, minimizing ambiguity and potential errors.

Emphasis on Purpose and Justification:

  • The form places a strong emphasis on the "Purpose of Access," requiring the requester to clearly articulate the business need for the data. This promotes responsible data usage and helps prevent unnecessary access.

Focus on Data Security and Compliance:

  • The inclusion of questions related to data sensitivity, security measures, and compliance requirements demonstrates a commitment to data protection.
  • Requiring the requester to acknowledge and understand relevant policies reinforces accountability.

Clear Structure:

  • The form is well-organized into logical sections, making it easy for requesters to navigate and provide the necessary information.

Manager Information:

  • Including the manager's name allows for easy verification of the requesters role, and for potential follow up if needed.
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