Access Change Request Access Change Request The intent of this form is to gather information about the user who needs the access and which specific things they need access to. Your Organization* Primary Point of Contact (Full Name):* Contact's Email Address:* Would you like to Allow or Remove access for this user?AllowRemove Effected user(s) (Usernames):* Access Type:File / SharePoint ApplicationEmail Distribution GroupOther What are the File Pathways?Path What application(s)? Are there specific modules?ApplicationModule What are the Email Distribution Groups?Distribution List Address What are the 'Other' things this user needs access changes to? DescriptionLocation Any additional configuration information or requests: I certify that I am authorized to make the Access Change Request being presented for technical service. I understand that no verbal or written warranty, expressed or implied, is offered on the services rendered by Cylanda. By accepting these services I agree that Cylanda cannot be held responsible for any damages to hardware, software, or Intellectual Property resulting from this service. Furthermore, Cylanda will not be liable for future damages or hardships resulting from any part of the services provided. I agree to release, indemnify and hold harmless any agent of Cylanda from liability for any claims or damages of any kind that may arise from this Access Change Request. I understand that the backup of any necessary data is my responsibility. Cylanda will not be held responsible for the loss or corruption of any data or application resulting from services rendered. I hereby authorize Cylanda to perform these services. In consideration for the services provided by Cylanda, I understand and agree to the terms and conditions stated above. *I agreeSubmitReset