Fillable Vpn Iso Review Telecomm R1 (California State University Channel Islands)

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Vpn Iso Review Telecomm R1 (California State University Channel Islands)

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Tel
ecommuter/VPN
Information Security Review
Form 02-004 (Use previous editions) VP for T&I/Information Security Revision 2/2017
Fill this form out as completely as possible. See instruction page.
Contact Information
VPN User
Administrator/Division VP
Name
Department
E-mail Address
Storage of Protected Data
Note: Definition of Level 1, 2, and 3 data may be found in CI policy IT.01.002.
1
Do you require access to and/or storage of Level 1 (confidential) or Level 2
(internal use only) data for your telecommuting duties?
If yes, you acknowledge that access and storage of Level 1 and Level 2 data is only
permitted using a university owned computer over the university approved VPN. If
you are not using a university owned computer or are not connected
to the
university VPN, you are not permitted to telecommute and/or access Level 1 or
Level 2 data.
Yes No
2
Will you need to print out Level 1 or Level 2 protected data for your
telecommuting duties?
If yes, please describe what steps will be taken to protect the printed data from
unauthorized access and disclosure including how you will destroy the printed data
when it is no longer required.
Yes No
Computer Use
Do you require access to the VPN in order to telecommute?
If YES, please complete and include a VPN Access Form which can be found at
http://www.csuci.edu/ti/policy/bphistory/vpn-access-form.pdf .
If N
O, please describe the specific hardware and software you will use with the
VPN.
**
Required only if using a personally owned computer.
Computer Vendor/Model Number:
Computer MAC Address:
Operating System/Version:
Antivirus Software/Version:
Web Browser Vendor/Version:
Yes No
Telec
ommuter/VPN
Information Security Review
Form 02-004 (Use previous editions) VP for T&I/Information Security Revision 2/2017
NOTE: Your configuration is subject to the review and approval of the Information
Security Officer and VP for Technology & Innovation.
I certify that this information accurately represents my use of protected data and VPN while
telecommuting. I agree that I will notify the T&I Help Desk immediately if any information on this form
changes.
___________
_______________________________ ___________
Signature of Employee Date
I have r
eviewed this information with my employee, and determined that the above safeguards, if any,
are sufficient to protect the University. I have attached, or otherwise provided, a written business
justification for the storage of Level 1 and Level 2 data by the telecommuting employee.
___________
_______________________________ ___________
Signature of Appropriate Administrator or Date
Division Executive if Level 1/Level 2 access
Disapproved
FOR T&I ADMINISTRATION USE ONLY
Administrative Approved
Signature
Date
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Telecommuter Information Security Review
Form 02-004 (Use previous editions) VP for T&I/Information Security Revision 2/2017
Instructions
Fill this form out as completely as possible, and submit it to the T&I Help Desk. Incomplete forms may
result in delays. If you have questions about this form, please contact the Information Security Officer or
the T&I Help Desk for consultation.
Consult T&I Business Practice BP-03-004, available at www.csuci.edu/ti/policy/bp-03-004.htm, for
details on T&I standards regarding the use of the CI VPN. Consult the Statement on Responsible Use of
Information Assets, available at http://policy.csuci.edu/statements/statement-on-responsible-use-info-
assets.htm, for details on acceptable use of T&I computing resources.
Division Executive/Administrator Approval
Your Division executive’s approval is required for the storage or printing of Level 1 and Level 2 data by
telecommuting employees. For all other employees, “Administrator” means your Manager.
Storage of Protected Data
“Protected data” means data that is defined as Level 1 or Level 2 by the CSU Data Classification
Standard. Please consult University Policy IT.01.002,
available at http://policy.csuci.edu, for definitions
of Level 1 and Level 2 data.
Computer Use
Except as authorized by the Information Security Officer and VP for Technology & Innovation, only
University-owned and –managed computers may be used on CI’s VPN.
To gather
the information required when using a personally owned computer, please consult your
hardware, operating system, and antivirus software documentation.
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Completed 20 July 2020

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