High-Privilege User VPN Approval Document
User Information
Full Name:
Job Title:
Department:
Employee ID:
Access Details
VPN Account Username:
Date Access Requested:
Requested Duration:
Justification for Access:
Systems / Resources Access Requested
System / Resource Name
Access Level
Reason
Risk Assessment (To be completed by IT/Security)
Risk Level:
Mitigating Controls Required:
Reviewer Comments:
Approval
Approver Name:
Title:
Signature:
Date:
User Acknowledgment
User Signature:
Date: