FORM NO: EDEV/F/01 ELECTRONIC DEVELOPMENT (MEDE) w.e.f: 01.12.

2012

REV NO: 00 PROJECT REQUEST FORM Date:

A CUSTOMER DEPARTMENT
1 CUSTOMER DEPARTMENT:
2 PROJECT TITLE:

3 PROBLEM/NEED:

4 KPI(s) IMPACTED:

5 POTENTIAL/EXPECTED BENEFITS:
FINANCIAL BENEFITS :- OTHER BENEFITS :-

6 PRIORITY/URGENCY OF TASK :
7 CUSTOMER REPRESENTATIVE:
NAME:- PERSONAL NO:-
PHONE NO:- EMAIL-ID:-
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SIGNATURE: ______________________________________ NAME: ______________________________________________

HEAD/CHIEF: ______________________________________ DATE: ______________________________________________

B ELECTRONIC DEVELOPMENT, MED(E)

1 PROJECT SCOPE:

2 REQUIRED TECHNICAL COMPETENCE:

3 EXPECTED PROJECT IMPLEMENTATION COST:

4 PROJECT EXECUTION TEAM:

5 FEASIBILITY OF PROJECT:

6 PRIORITY OF PROJECT EXECUTION:

7 KPI(s) IMPACTED:

8 EXPECTED PROJECT FEASIBILITY STUDY REPORT DATE:

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SIGNATURE: ______________________________________ NAME: ______________________________________________

DESIGNATION: ______________________________________ DATE: ______________________________________________