PeopleSoftAccessRequestForm
CIFinancials/LCDPayroll
Re
ports
Work
Order
#
Requestor:

Ext:

RequestType:
New Modify Delete
Step1: UserInformationAppropriateSupervisorPleaseverifythissection.
Name(FirstM.Last):PSEmployeeID
:
EmailAddress: WorkPhone#
:
Position/JobFunction:Department
:
Step2: AppropriateSupervisorPleasecompletethissection,reviewwiththeappropriateSecurityLead,print,sign
andreturnformtotheT&CHelpdeskforassignmentandprocessing.
PeopleSoftPayrollDept(s):
CFSSecurityRole(s)Requested: CFSCCI_EU_FinInquiry_02CFSCSU_FS_DWReporting_02CFSCSU_PT_PeopleSoft_User
CFSCSU_AP_Inquiry_01 CFSCSU_FS_DWReporting_03CFSCSU_PT_Process_Monitor
CFSCSU_AP_ProCard_02 CFSCSU_PO_Inquiry_01 CFSCSU_PT_Query_Viewer
CFSCSU_FS_DWReporting_01 PAPP_USER

OtherRole(s)Requested:
BusinessUnitAccess(Circlebusinessunitsrequested)
PrimaryPermissionList:(Administrative Use Only)
CompletedCMSAccessandComplianceForm:
Yes
No
AppropriateSupervisor Signature Date
Step3: Authorizations‐PleaseobtainsignaturesbeforesubmittingformtotheT&CHelpdesk
TheemployeeidentifiedaboveisapprovedandcertifiedtoreceivetherequestedPeopleSoftaccess.
Lacey
Lovejo y
(Director,
Financial
Systems)
Signature

Date
PeopleSoftSecurityAdministrator
Comments:
Print:
Signatu re

Date
CIASI CICMP CICSA CICSU CIFDN CIGAP CIUGC
CSFCI_PP_
My signature below certifies that the above named employee requires access to data in a computer-based information system
because such data is relevant and necessary in the ordinary course of performing his/her job duties. I understand my obligation to
provide training to this employee to ensure that he/she understands the state and federal laws, and University policies that govern
access to and use of information contained in administrative (including employee, applicant and student information) and academic
records accessible through computer-based information systems. Please ensure you have reviewed the above information with the
appropriate Security Lead(s) before signing this form.
CFS PSAR - Last updated 11/20/2014