1601 FR.03 Sponsored Identity Request Form – Instructions

1601 FR.03
Sponsored Identity Request Form – Instructions
PURPOSE OF THE FORM
This form is to be used for submitting requests for the creation, modification, deactivation and reactivation of Sponsored Identities.
See Procedure 1601 PR08 for more information on Sponsored Identity eligibility.
INSTRUCTIONS
1.
Only an active faculty or staff can request a Sponsored Identity, or request modifications to an existing Sponsored Identity.
2.
Each field marked as required must be populated (see table below for detailed instructions).
3.
Lead Administrators/Operation Managers are responsible for verifying that the applicant requires the access requested and that a business or
academic need exists.
4.
All authorized requests should be forwarded to Operations Manager, Business Operations (Nancy Scanlon) for final review –
([email protected]).
5.
After final review, form is forwarded to HR Transaction Center for data entry in Oracle EBS (HR).
6.
After data in from form is entered into Oracle EBS (HR), the form should be archived.
Note: Entry of information is required for all fields, except when marked optional
FORM AREA
REQUIRED INFORMATION
REQUESTED BY
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Name of individual filling out the request
Name of individual authorizing the request
DATE
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REQUEST TYPE
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The type of request being made (only one type should be selected per request)
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Name of the individual sponsoring the Sponsored Identity (must be a Yale employee)
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Current NetID of Sponsored Identity (not required if request is for a new sponsored identity)
NAME
PHONE
SIGNATURE
DATE
Phone number of the individual filling out the request
Signature of the individual filling out the request
Date the signature was applied to the request form by requester
AUTHORIZED BY
NAME
PHONE
SIGNATURE
Phone number of the individual authorizing the request
Signature of the individual authorizing the request
Date the signature was applied to the request form by authorizer
REQUEST TYPE
SPONSOR INFORMATION
NAME
TITLE
ORACLE HOME ORG
Position of individual sponsoring the Sponsored Identity
Home Organization of the individual sponsoring the Sponsored Identity
IDENTITY INFORMATION
NET ID
ROLE
EFFECTIVE START DATE
EFFECTIVE END DATE
FIRST NAME
LAST NAME
GENDER
HOME STREET ADDRESS
CITY/TOWN
STATE
POSTAL CODE
DATE OF BIRTH
Role of the Sponsored Identity
Only one Role should be selected per request form
Only required for creation requests and modification requests where Role needs to be updated
Effective Start Date for the Sponsored Identity (when they should become an active identity)
Effective End Date for the Sponsored Identity (when they should be deactivated or re-attested)
Legal First Name of Sponsored Identity
Legal Last Name of Sponsored Identity
Gender of Sponsored Identity
Home Street Address of Sponsored Identity
City/Town of Sponsored Identity (part of home address)
State of Sponsored Identity (part of home address)
Postal Code of Sponsored Identity (part of home address)
Date of Birth of Sponsored Identity
SOCIAL SECURITY NUMBER
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Social Security Number of Sponsored Identity
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Business reason for making the Sponsored Identity request (not required for deactivation requests)
SUPPORTING INFORMATION
BUSINESS REASON
ADDITIONAL INFORMATION
Additional information pertinent to the request (optional field)