Human Resources Portal Access Form 6/3/20, 7/13/20
RCUH FINAL REVIEW (RCUH ONLY)
__________________________________ ______________
Signature of Final Reviewer Date
Effective Date:
Attach. B: ☐Required ☐ Exempt
☐
☐ E
☐
Update User Access PI Change
Create New DC Cancel DC
Email to: RCUH_HRIS@rcuh.com
Human Resources Portal Access Form
I. DISTRIBUTION CODE INFORMATION
Requested DC: _________ Project Name: ____________________________ Requested Effective Date: ___________ Request:
eTimesheet Approvers – Primary: ____________________________ Secondary: ____________________________ (must be listed in Section II as PI
1
or SA
1
/SA
2
)
II. LIST ALL CURRENT USERS
The users listed below represent the current users that the PI of record is granting access to their project numbers and
employee information under the requested DC. If an individual is not listed below, they will not have access to the requested DC.
Employer
Add or Update
Name / Email / Phone
All
RCUH, UH, or Other
Attach if Adding
RCUH Employee
*Principal Investigator
PI1
PNF / JD
*Fiscal Administrator
FA1
FMO-1 / JD
Fiscal Administrator
FA2
FMO-1 / JD
*Supervisory
SA1
Job Description
Supervisory
SA2
Job Description
Administrative
AA1
Administrative
AA2
Temporary Access – 20 Weeks Max. Access Type: PI FA SA AA From: To:
Name: Email: Phone:
PNF / FMO-1 / JD
III. ADDITIONAL USERS – A memo from the PI must always be attached to the request to justify the additional users.
Employer
Attach if Adding
RCUH Employee
Action
Add or Update
Access Type Name / Email / Phone
All
RCUH, UH, or Other PNF / FMO-1 / JD
IV. CANCEL USER ACCE
SS: ________________________________________________________________________
V. PRINCIPAL INVESTIGATOR – ACKNOWLEDGEMENT & APPROVAL
I hereby acknowledge and approve access to the users listed above for the requested DC. I’m ultimately responsible for certifying the accuracy and authenticity of all
transactions and time reporting processed for employees, regardless of additional system access granted to the users listed above. I will convey the importance and
definition of the access type, duties, and responsibilities to the listed users that I have granted access.
Signature: _________________________________________ Date: __________________
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