In keeping with NIST 800, DORS is required to identify all staff that have access to our agency's applications for auditing purposes. Application defined owners, supervisors, directors, program chiefs or staff specialists must complete this form every time an employee needs access or no longer requires access to the application.
Employee's needing access include both new employee's as well as current staff reassigned to you programs with the agency.
Employee's no longer requiring access include staff leaving the agency or reassigned to another program.
Only the defined "Owner" of the application can complete this form. By definition an application Owner is the individual with the responsibility to ensure that the program or programs, which make up the application, accomplish the specified objective or set of user requiremeBnts established for that application, including appropriate security safeguards. Once submitted, the completed form will be emailed to the MIS Director who is currently defined as the Security Manager for these applications. After reviewing the form, the MIS Director will follow up with the Application Owner to confirm that they did indeed submit the form and agree with the employee security change request.
Do not contact Jennifer Gasiorowski directly for staff changes.
All fields on the form are required.
Before the form is submitted you have the opportunity to review you answers. If you made a mistake you can use the Back button to make corrections. At this point you can save a copy for your records by click on the link "Download PDF Version" in the lower left corner.