Free form template · Word

Application Access Request

An application access request form is used to get a user ID and role in a business application such as ERP, CRM, HRMS or accounting software. It records the modules, role, branch or company code and transaction limits needed, checks for conflicting roles, and is approved by the manager and the application owner.

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[Company Logo][Company Name]

APPLICATION ACCESS REQUEST FORM

Request No.:: [Reference Number]
Date:: [Date]
Request Type:: New User / Additional Role / Change in Limit / Remove Role

1. User Details

Name	[Employee Name]
Employee ID	[Employee ID]
Designation	[Designation]
Department	[Department]
Branch / Location	[Work Location]
Reporting Manager	[Reporting Manager]
Official Email	[Email ID]

2. Application and Role Details

Application	Module	Role (from catalogue)	Data Scope (Company / Branch / Territory)	Approval Limit (₹)	Justification
[ERP / Accounting Software]	[Module]	[Role Name]	[Company Code / Branch]	[Amount]	[Justification]
[CRM]	[Module]	[Role Name]	[Territory]	-	[Justification]
[HRMS / Payroll]	[Module]	[Role Name]	[Entity]	-	[Justification]

Access required from	[DD/MM/YYYY]
Access required till: Permanent / [DD/MM/YYYY]
Licence type: Full / Limited / View-only

3. Segregation of Duties Check (Application Owner)

No conflict with roles already held by the user
Conflict found: [Role A] with [Role B] – compensating control: [Details]
Licence available / to be purchased

4. Approver Chain

Level	Approver	Name	Decision	Date
1	Reporting Manager	[Reporting Manager]	Approved / Rejected	[DD/MM/YYYY]
2	Application Owner	[Application Owner Name]	Approved / Rejected	[DD/MM/YYYY]
3	Finance Controller (finance roles and limits)	[Finance Manager]	Approved / Rejected	[DD/MM/YYYY]
4	IT / Application Admin	[IT Executive Name]	Provisioned	[DD/MM/YYYY]

5. Provisioning Record

Application user ID	[User ID]
Roles assigned	[Role Names]
Provisioned on	[DD/MM/YYYY]
Training on the module completed: Yes / No

6. User Declaration

I will use the application only within the role and limits approved above, keep my password confidential, and not perform transactions on behalf of other users. I understand that application activity is logged and audited.

User
[Employee Name]
Date: [Date]

Application Owner
[Application Owner Name]
Date: [Date]

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What this template includes

Application and module with exact role name
Data scope such as company code, branch or territory
Transaction or approval limits in rupees
Segregation-of-duties check to avoid conflicting roles
Licence availability check
Approval by manager, application owner and IT

When to use it

A new accountant needs access to the accounting or ERP system
A sales executive needs a CRM licence and territory
An HR executive needs HRMS or payroll access
An employee needs an additional module or approval limit

How to customise this template

1List your business applications and their owners
2Insert the standard role catalogue for each application
3Define role combinations that are not allowed, such as create vendor plus approve payment
4Add your approval-limit slabs
5Use the system access request form for servers and shared drives

HR tips

Ask for role names from a catalogue instead of 'same as colleague'
Check for conflicting roles before approving finance or payroll access
Set approval limits explicitly in rupees
Copy the signed form to the application owner for their records

For HR & hiring managers

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Frequently asked questions

What is segregation of duties in application access?+

It means one person should not hold roles that let them complete a sensitive transaction end to end, such as creating a vendor and approving its payment.

Who is the application owner?+

The business head responsible for the application, such as the finance controller for ERP finance or the HR head for HRMS. They decide who gets which role.

Can access be copied from another user?+

It is better to avoid 'copy user' requests, because the other user may have excess access. Request specific roles instead.

All 50 it assets, admin & company property →

[Company Logo][Company Name]

SYSTEM ACCESS REQUEST FORM

Request No.:: [Reference Number]
Date:: [Date]
Request Type:: New / Modify / Temporary / Elevated
Ticket Ref.:: [Ticket Number]

1. Requester Details

Name	[Employee Name]
Employee ID / Vendor ID	[Employee ID]
Designation	[Designation]
Department	[Department]
Reporting Manager	[Reporting Manager]
Existing User ID (if any)	[User ID]
User type: Employee / Contractor / Vendor engineer

2. Access Requested

System / Server / Resource	Role or Group	Access Level	From	To	Business Justification
[Domain / Active Directory group]	[Group Name]	Read / Write / Admin	[DD/MM/YYYY]	[DD/MM/YYYY]	[Justification]
[File server / shared drive path]	[Folder]	Read / Write	[DD/MM/YYYY]	[DD/MM/YYYY]	[Justification]
[Server name / IP]	[Role]	Read / Admin	[DD/MM/YYYY]	[DD/MM/YYYY]	[Justification]
[Database]	[Schema / Role]	Read / Write	[DD/MM/YYYY]	[DD/MM/YYYY]	[Justification]

3. Approver Chain

Form · Word

System Access Request

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[Company Logo][Company Name]

VPN / REMOTE ACCESS REQUEST FORM

Request No.:: [Reference Number]
Date:: [Date]
Request Type:: New / Extension / Vendor / Temporary (travel)

1. User Details

Name	[Employee Name]
Employee ID / Vendor ID	[Employee ID]
Designation	[Designation]
Department	[Department]
Reporting Manager / Vendor Coordinator	[Reporting Manager]
Vendor Company and Contract Ref. (if vendor)	[Vendor Name] / [Reference Number]
Mobile for MFA	[Mobile Number]

2. Reason for Remote Access

Approved hybrid / remote work arrangement
On-call or after-hours support
Business travel
Vendor maintenance or support
Other: [Specify]

3. Device Details

Form · Word

VPN Access Request

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[Company Logo][Company Name]

DATA ACCESS REQUEST FORM

Request No.:: [Reference Number]
Date:: [Date]
Access Type:: One-time Extract / Recurring Report / Read Access to Database / Share with Vendor

1. Requester

Name	[Employee Name]
Employee ID	[Employee ID]
Designation	[Designation]
Department	[Department]
Reporting Manager	[Reporting Manager]

2. Data Requested

Dataset / system / report name	[Dataset Name]
Data owner	[Data Owner Name]
Classification: Internal / Confidential / Restricted
Period covered	[DD/MM/YYYY] to [DD/MM/YYYY]
Frequency: One-time / Weekly / Monthly

Field / Column	Needed for	Personal Data?	Masking Acceptable?
[Field Name]	[Purpose]	Yes / No	Yes / No
[Field Name]	[Purpose]	Yes / No	Yes / No
[Field Name]	[Purpose]	Yes / No	Yes / No
[Field Name]	[Purpose]	Yes / No	Yes / No

Form · Word

Data Access Request

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[Company Logo][Company Name]
FACILITY ACCESS REQUEST FORM
Request No.:
[Reference Number]
Date of Request:
[Date]
Facility / Site:
[Work Location]
Access Type:
After hours / Weekend / Holiday / Other site / Special area
1. Requester
Name [Employee Name]
Employee ID [Employee ID]
Designation [Designation]
Department [Department]
Mobile Number [Mobile Number]
Supervising employee on site [Employee Name]
2. Access Details
Date(s) [DD/MM/YYYY] to [DD/MM/YYYY]
Time [HH:MM] to [HH:MM]
Areas required [Floor / Room / Warehouse / Training Hall]
Purpose [Purpose]
3. People Entering
Form · Word
Facility Access Request
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Date(s)	[DD/MM/YYYY] to [DD/MM/YYYY]
Time	[HH:MM] to [HH:MM]
Areas required	[Floor / Room / Warehouse / Training Hall]
Purpose	[Purpose]

[Company Logo][Company Name]

ACCESS CARD ISSUE FORM

Request No.:: [Reference Number]
Date:: [Date]
Site / Building:: [Work Location]
Request Type:: New / Additional Access / Replacement / Temporary

1. Card Holder Details

Name	[Employee Name]
Employee ID / Vendor ID	[Employee ID]
Designation	[Designation]
Department	[Department]
Category: Employee / Contractor / Intern / Consultant
Shift Timing	[Shift Timing]

2. Access Required

Zone / Door	Required (Yes/No)	Days	Time Window	Business Justification
Main entrance and reception	Yes / No	Mon–Sat	[HH:MM] to [HH:MM]	[Justification]
Floor [Floor] work area	Yes / No	[Days]	[HH:MM] to [HH:MM]	[Justification]
Server / network room	Yes / No	[Days]	[HH:MM] to [HH:MM]	[Justification]
Store / record room	Yes / No	[Days]	[HH:MM] to [HH:MM]	[Justification]
Parking / basement	Yes / No	[Days]	[HH:MM] to [HH:MM]	[Justification]

Access valid from	[DD/MM/YYYY]
Access valid till	[DD/MM/YYYY] / Until exit

Form · Word

Access Card Issue Form

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[Company Logo][Company Name]
ACCESS CARD RETURN AND DEACTIVATION FORM
Ref. No.:
[Reference Number]
Date:
[Date]
Site / Building:
[Work Location]
Return Type:
Full Surrender / Partial Zone Withdrawal
Card Holder
Name [Employee Name]
Employee ID / Vendor ID [Employee ID]
Department [Department]
Reason: Exit / Contract End / Transfer / Role Change / Card Damaged
Effective Date and Time [DD/MM/YYYY] [HH:MM]
Card Surrendered
Card No. Card UID / Serial Physically Returned Condition Disposal
[Card Number] [Serial Number] Yes / No Good / Damaged Reuse / Destroy
Zone Access Revoked
Form · Word
Access Card Return Form
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Card No.	Card UID / Serial	Physically Returned	Condition	Disposal
[Card Number]	[Serial Number]	Yes / No	Good / Damaged	Reuse / Destroy

[Company Logo][Company Name]

EMAIL ACCOUNT CREATION REQUEST

Request No.:: [Reference Number]
Date:: [Date]
Requested by:: [HR Name] / [Reporting Manager]
Required by:: [DD/MM/YYYY]

1. Request Type

New employee mailbox
Contractor / consultant mailbox (time-bound)
Shared / functional mailbox (e.g. support@)
Additional alias / name change

2. User Details

Full Name	[Employee Name]
Employee ID / Vendor ID	[Employee ID]
Designation	[Designation]
Department	[Department]
Date of Joining	[Date of Joining]
Work Location	[Work Location]
Personal email for credential delivery	[Personal Email]
Mobile for MFA setup	[Mobile Number]

3. Mailbox Details

Form · Word

Email Account Creation Request

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[Company Logo][Company Name]

EMAIL ACCOUNT CLOSURE REQUEST

Request No.:: [Reference Number]
Date:: [Date]
Requested by:: [HR Name]
Priority:: Normal (last working day) / Urgent (immediate block)

1. Account Details

Employee Name	[Employee Name]
Employee ID	[Employee ID]
Department	[Department]
Email ID	[Email ID]
Aliases / shared mailboxes owned	[Details]
Last Working Day	[Last Working Day]

2. Closure Instructions

Action	Required	Details
Block sign-in	Yes	On [DD/MM/YYYY] at [HH:MM]
Auto-reply	Yes / No	For [Number] days
Forward incoming mail	Yes / No	To [Email ID] till [DD/MM/YYYY]
Delegate access to manager	Yes / No	[Reporting Manager] till [DD/MM/YYYY]
Convert to shared mailbox	Yes / No	Owner: [Owner Name]
Remove from distribution lists	Yes	All
Transfer ownership of shared mailboxes	Yes / No	To [Employee Name]

3. Auto-Reply Text

Form · Word

Email Account Closure Request

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Application Access Request

Preview of the form

1. User Details

2. Application and Role Details

3. Segregation of Duties Check (Application Owner)

4. Approver Chain

5. Provisioning Record

6. User Declaration

What this template includes

When to use it

How to customise this template

HR tips

Hire top talent from BetterJobs

Frequently asked questions

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