ADVS IT User Access Closeout/Suspension Form

ADVS IT User Access Closeout/Suspension Form

(rev. 2023-03-28 it/lq)
This online request form is to be utilized by authorized ADVS staff ONLY (typically managers), to request suspension or termination of the named User's agency resource access rights.

Special Notes, Policiers, Guidelines, Constraints:
1. Provide at least 2 hours notice, during normal business hours (by 2pm), for rapid account access suspensions.
2. Allow 2-to-5 business days for full completion of User Closure Requests, including email delegation, user file backup, and other delegation and authorization closeout.
3. Remember that all personnel and access rights information and activities are confidential to the affected manager, and within the HR and IT units, with such information never being shared with personnel beyond those boundaries.
4. Got questions? Contact ADVS IT helpdesk at helpdesk@azdvs.gov or telephone 602-263-1848
Requester's Agreement*

Requester's Name*

First NameLast Name
Requester's Employee ID#*
AZ EIN required
Requester's Position/Title*
Requestor's Email*
must be a properly formatted, existing agency email address
Requestor's Telephone#*
Separated User's Name*

First NameLast Name
Separated User's Position/Title*
Separated User's Email Address
must be a properly formatted, existing agency email address
Type of Action Requested*
ATTENTION MANAGERS: Ensure your Action Date and Time below are absolutely correct, as we generally act on requests "to the letter" assuming you know what you want. If your information is incorrect and we act on it, creating an HR or other (potentially embarrassing) situation, the responsibility will be yours. DOUBLE CHECK your Dates and Times.
Date & Time of Action*

YearMonthDayHourMinutesAM/PM Option
Target Date (if known) of Rights Resumption - in case of Suspension*
Should we forward the users email to someone else?
To whom (enter the current staff name and/or email address to delegate to):*
Staff Name and/or Email Address or enter N/A, if not applicable
Should we delegate the User's Data to a person?
To whom (enter the person's name or email to delegate to):*
Staff Name and/or Email Address or enter N/A, if not applicable
If applicable, Computer System's AZ Asset Tag(s) and current Location*
Collect User's ADVS Cellphone?*
User's ADVS Cellphone Number (if applicable)
User's eFax #*

Not applicableOther
User's eFax Number (if applicable)*
Enter (000) 000-0000 if not applicable
User's Desk Phone Action?*
User's Desk Phone Number?
Other comments for IT Team regarding Termination or Suspension of this User's Resource Access Rights from current role:
Collection of Agency Equipment and Other Work Items

When planning for separation of staff, any assigned IT equipment comes to mind for collection and return to IT for repurposing. However, the separating staff member usually needs to complete a final time sheet (manually), as well as return any badges, keys, pCards, and other agency-owned items to you as their supervisor or to any other issuing authority.

Please remember all agency-assigned items when planning for a staff member separation.
Requester's Agreement*
Manager's/Requester's Signature*

Clear
Should be Empty: