WEST VIRGINIA OFFICE OF TECHNOLOGY
MAINFRAME REQUEST
Add Modify Delete
Full Name:
Last 4 Digits of SSN:
Full Address: «AddressBlock»
Phone Number:
Email Address:
Agency:
Logon Prefix (ie- SA#, IS#, etc)
PAS#
TSO User? Yes
No
Default Printer – List your printer ID or no ID will default to the Office of Technology
Printers
Computer Room Box Number
TPX Menu – List any items which you need on TPX menu (ie-WVFIMS, HRIS, CICS, etc.)
Agency Authorization Signature and Print Please Date
Please email this completed form to naf@wv.gov
click to sign
signature
click to edit