PBG-IT-TMP-MDM-001

SAP ID Creation & Authorization Request Form

GDC
Call Ref No
New SAP ID Authorization ID Deletion
Creation Request Request Request

Administrative Information (furnished/filled by the User)

Name

Company Login ID
(if exist)
Department Employee ID

Communication Information (furnished/filled by the User)

Email Location

Mobile/Extn Language EN-English

Technical Information (furnished/filled by functional team leader/BASIS Administrator)

Client No. System ID

Module Printer LOCL

………………………………………………………………………………………………………………...............................................
Description of the required authorization(s)

Details
Tran. Code Description Authorization Given Tested by Basis Tested by Functional

User trained and well versed in SAP application usage

Requester Dept Head Functional Head/Process PBG CIO/CFO

Owner
Name Name Name Name

Signature Signature Signature Signature

Date Date Date Date

Note: Complete form in all respects will only be accepted and entertained with the request for authorization. In case the existing
form is not sufficient to fill in all the details please attach additional sheets for details.