TO BE FILLED IN BLOCK LETTERS

IT Access Requisition Form

DATE
EMPLOYEE / CONSULTANT DETAILS
FIRST NAME MIDDLE NAME LAST NAME
Pradeep N Menon
EMPLOYEE/CONSULTANT ID DEPARTMENT / PROCESS DESIGNATION
INFX06590 Quality and Compliance Associate Director
LOCATION
ACCESS REQUIRED
☐ Local machine admin rights
☐ USB media port
☐ VPN Access
☐ Internet / Wi‐Fi
☐ Mailbox / OWA/ Mobile device email
☐ Shared Drive
☐ VOIP calling/ DiD / ZOOM / Vonage
☐ O365 subscriptions (Office suite/Teams/Skype for Business)
☐ Printing
☐ Others (Specify)

AUTHORIZED BY
NAME DESIGNATION SIGNATURE DATE
Hiren Kulkarni CEO Refer to Hiren’s mail 2 Apr 2021 nd

* Granting access may take up to one business day after submission of form to IT Service Desk.
* Subject to approval of business justification by CISO, when applicable.
* Access granted should be used responsibly for official assignments ONLY, adhering to Infinx & Client policies.
* In case of violation user will be liable for disciplinary action leading to termination or prosecution.

POST ISSUANCE DETAILS

PURPOSE FOR Refer to ticket - 47971

THIS ACCESS Updates on Application such a Minitab, ASQ, isixsigma, adobe etc.. needs
updation of files/apps … this requires updates to run which requires admin
access.
RECEIVED BY
Name Pradeep Menon
Designation Associate Director – Quality and Compliance
Signature N.Pradeep
Date 8th Apr 2021
FOR IT DEPARTMENT ONLY
Name Signature Date
Granted by
Approved by

Version 1.1 For internal use only. 1|P a ge

INFX/ITF/F2