Application / System / Internal Resource Access Request Form

Date:

System / Resource Details: ISL Webcare / MPOS

Should all the necessary info not provided in full, your login account will NOT be created.
The respective departmental Managers’ signatures must accompany this application as this will
serve as approval to the staff member’s access request.

Requestor’s Information and details

Username
Full Name Single user? Yes
Email
ForNumber
Phone a list of users, kindly provide a separate file attached to this form with details in a table
Department
Position
Supervisor / Manager
Distribution Channel
State or Region
City and Site or Location
as indicated below for each user:

Username Full Name Telephone Number email address Signature

Profiles, Roles and Permissions requested (Please select only what is applicable)

Sen Profiles Description

siti Indiv+Corp_GSM Individual and Corporate GSM Registration
vity
Indiv+Corp_GSM_SIMSW Individual and Corporate GSM Registration, SIM Swap
:
Indiv+Corp_GSM_S+V Individual and Corporate GSM Registration, Search and View
MT
N
Int
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Indiv+Corp_GSM_SIMSW_S+V
Indiv_Corp_GSM_DNA
Indiv+Corp_GSM_S+V+E
Indiv_Corp_GSM_SIMSW_DNA
Indiv_GSM
Individual and Corporate GSM Registration, Search, View and SIM x
Swap
Individual and Corporate GSM Registration, Dynamic Number
Allocation
Individual and Corporate GSM Registration, Search, View, Edit
Individual and Corporate GSM Registration, SIM SWAP, Dynamic
Number Allocation
Individual GSM Registration

Indiv+Corp_GSM+MoMo_S+V+E_A+R Individual and Corporate GSM Registration, Momo Registration,

(Eyeballing) Search, View, Edit, Accept + Reject
Indiv+Corp_GSM_S+V+E_A+R Individual and Corporate GSM Registration, Search, View, Edit,
(Eyeballing) Accept + Reject
Indiv+Corp_GSM_S+V_A+R Individual and Corporate GSM Registration, Search, View, Accept +
(Eyeballing) Reject
Indiv_GSM_SIMSW_S+V Individual GSM Registration, SIM Swap, Search and View

Individual and Corporate GSM Registration, SIM Swap, Search,

Indiv_Corp_GSM_SIMSW_S_V_CAT2_Bulk View, Category2, Bulk registration
Individual and Corporate GSM Registration, SIM Swap, Search,
Indiv+Corp_GSM_SIMSW_S+V+E View, Edit
Indiv_GSM_S+V Individual GSM Registration, Search, View

Individual and Corporate GSM Registration, Search, View, Edit,

Indiv_Corp_GSM_S_V_E_A_R_Bulk Accept+Reject, Bulk registration
Individual and Corporate GSM Registration, SIM Swap, Search,
Indiv_Corp_GSM_SIMSW_S_V_CAT2 View, Category2

Access owner Information

Username
First Name
Last Name
Email
Phone Number

Does an account already exist on the system for the access requestor?

No
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 Access request details
Permanent Access? No
Access decommissioning date:
SoD Analysis:
SoD Recommendation:
Is Access approved? Yes No

Access requestor Requestor’s Supervisor

Name Name GAGBO SYLVESTRE
Signature Signature
Date Date
Requestor’s Manager Access Owner
Name Name
Signature Signature
Date Date
Service Desk Head Of Department
Name Name
Signature AccessSignature
Approvals
Date Date

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