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INTERNAL USE ONLY

GROUP IT Issue Date: 24/01/11


Issue / Rev No: 1.0

RISK ACCEPTANCE FORM

For unsuccessful UAT but when change has to For last minute changes
be implemented in production systems

UAT performed on
(dd-mm-yyyy)

Number of users tested

Description of UAT failure


(Please clearly indicate
reasons for UAT failure)

Justification for
performing change in
production systems
despite UAT failure

Change Requester
acceptance (Yes/No)

Change Requester
remarks (if any)

Change Assignee
acceptance of risk
ownership

Department Head System Owner ITRE

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