Project Change Request

PROJECT INFORMATION
Client: Project Name / Acronym: Project Manager: Client Name Project Name/Acronym CCI PM Name

CHANGE IDENTIFICATION
Change Request Number: Requested By: Phone Number: Date Identified: Date Required: CR01 Requestor Name 416-712-7499 Apr 13, 2010 MMM DD, 2010 Priority Level: Mandatory Necessary Desirable

CR INFORMATION
Description/Impact: Provide description of the CR and its impact on the project Bullet Points Meet with Key Stakeholders to Review Requirements Justification: Many of the users today have . Impact of Not Approving Framework Manager Effort impact? Cost impact? Functionality impact?

Alternatives Leave Framework Manager ..

IMPACT ANALYSIS APPROVAL

Proceed to Impact Analysis Approval Authority: Title: Approved Approver Name Approver Title Deferred to mmm, dd,yyyy Submission Date: Cancelled Apr XX, 2010

Copperstone Connect
125119343.doc

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Project Change Request

PROJECT IMPACT
Impact Analysis Cost: Change Request Cost: Total Cost: Schedule Impact Impact Analysis Effort Change Request Effort Impact Analysis Completion: Impacted Project(s): $0.00 $675 reduction $675 reduction 1 day ahead of schedule 0 days 4 days Apr XX, 2010 None Revised Milestones 1) Initial Meetings 2) Feedback Session 3) Final Report 3) Final Report 4) Current Inventory 5) Roll-Out Oct 31, 2006 Nov 23, 2006 Dec 5, 2006 Dec 5, 2006 Dec 18, 2006 Dec 18, 2006

CR APPROVALS
Change Request is: Keyrus Signature: Name: Title: Approval Date: CCI Name Project Manager MMM DD, YYYY Approved Deferred Name: Title: Approval Date: yyyy/mm/dd Cancelled Approver Name Approver Title MMM DD, YYYY Client Signature:

ADDITIONAL INFORMATION
Provide reason(s) for canceling or deferring change, or any other additional pertinent information

Copperstone Connect
125119343.doc

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