iNeOM UAM - Form Request User Vicky Riandi

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FORMULIR USER iNeOM

*Note: requestor wajib mengisi form untuk huruf yang dicetak biru
AREA Kantor Pusat Regional I Regional II Regional III Regional IV Regional V Regional VI Regional VII Regional VIII Regional IX Regional X Regional XI

IDENTITAS REQUESTOR PENGESAHAN


Approval
Nama Lengkap : Vicky riandi Approver Nama Email Phone Status

Jenis Kelamin : L Requester Mohamad Adi Prayogo mohapray@gmail.com 085322735869


Tanggal Lahir : 22 September 1996 Superior
No Kartu Identitas : 3672050306950002 Reviewer-1
Perusahaan : PT. APS Reviewer-2
NIK : Admin iNeOM
Posisi Jabatan :
Dept/Divisi :
Lokasi/Lantai : CATATAN
RTP/Cluster :
Phone : 0813-1715-7021 / 089515413713
Email Kantor : vickyriandi2@gmail.com
Waktu Akses : 12 Bulan
Akses Mobile – IMEI 1 : 359302103506124
Akses Mobile – IMEI 2 : 359303103506122
Akses Mobile – IMEI 3 :

JENIS REQUEST

User Baru Perubahan User Deaktivasi User

KEPERLUAN AKSES USER


Incident Management ADMIN USER
Asset Management Site Maintenance Incident Remedy
Username :
Password :
PRIVILEGE
Group :
Viewer Admin HQ Comment :
Mitra Regional Section

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