<Project Name>

Scope Change Request

Date Submitted: <mm/dd/yyyy>
Department: <Department>
Focus Area: <Focus Area>
Product or Process: <Product or Process>
Investigator: <Investigator>
Project or Organization Role: <Role>

Scope definition and impact on other projects and programs

Business and system drivers

Business and system impact

Scope change benefit

Implication of not making change

Scope change cost estimate

Related documentation

Scope change approved for investigation? Yes

Assigned Investigator: <Investigator>

Approved by: <Approver>
Title: <Title>
Date Approved: <mm/dd/yyyy>

Comments
projects and programs

Yes No
<Project Name>
Scope Change Impact Assessment
Investigator:
Date Submitted:

Impact on other projects and programs

Issues

Risks

Skill required

Scope change cost estimate

Schedule impact

Impact on systems

Related documentation

Impacted documentation
Business case
Requirements
Specifications

Recommendations
Change Control Board Decision

Assigned Investigator:
Approved by:
Title:
Date Approved:

Comments
roject Name>
ope Change Impact Assessment
<Investigator>
<mm/dd/yyyy>

ct on other projects and programs

es

required

pe change cost estimate

dule impact

ct on systems

ted documentation

cted documentation
usiness case Schedule Design
equirements Cost/Budget Plan Code
pecifications Resource Plan Test Cases

Deferred
nge Control Board Decision Approved Deferred Rejected

<Investigator>
<Approver>
<Title>
<mm/dd/yyyy>
<Project Name>
Cost Assessment
Department: <Department>
Focus Area: <Focus area>
Product or Process: <Product or Process>
Document Owner: <Document Owner>
Project or Organization Role: <Role>

Labor Total
Labor Material Travel
ID Task Cost per Labor Other Cost Total Cost
Hours Cost Cost
Hour Cost
$0 $0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
Subtotal 0 $0 $0 $0 $0 $0
Contingency Reserve
Total $0

Comments: