Shared Folder Access
Permissions Change Form
ACCOUNT INFORMATION: This section provides details about the user who needs access
granted/revoked/modified for the folder share(s) listed in this document.
First Name: Last Name:
SHARE INFORMATION: This section provides details about the share(s) for which this user will need to
have access granted/revoked/modified. W=Write, RE=Read and Execute, M=Modify, RA=Revoke Access
(“Read and Execute” Allows the user to read existing files and open any existing applications)
(“Write” Allows the user to create new files)
(“Modify” Allows the user to modify any existing files)
(“Revoke Access” Removes any existing permissions)
Share Path: (ex. \\ServerName\SharePath
) Requested Permissions:
APPROVAL: This request must be approved by the share's department/division head. By signing below
the department/division head is granting ITS permission to make all changes described in this form. In
addition, the department/division head is assuring that they understand the level of access being
granted to the user listed in this form.
Department/Division Head Signature:
ITS NOTES: This section is for ITS use only.
Changes Made By: Date:
Notes: See Reverse Side.