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User Request Form /IT/VII/2018
User Information
Name Request date:
Title
Dept/Div
Telp / Ext Region/ Location : Floor :
Email
Request Type (*)
Create Billing System Role:
Delete CRM Role:
Change Ticketing System CCR: Service Team:
Install Cisco Call Center Team Name: Inbound Outbound
Other Local SLJJ Cellular International
CIPC CAD CSD Mediasense IVR
Broadcast SMS Email TVMS
VPN Access / Duration:
IPTV (**) IPTV IQAS IPTV SLCS
IPTV Statistic IPTV Envivio NMS
Network Element (**) NE Corporate NE Retail
Full Access View Only
NMS Netnumen Cacti Retail Cacti Corp.
WUG U2000
Pin Telp (**)
Line Telp (**) New Relocation
Software / Application Name
User Login Active Directory
Folder Sharing / Name (***)
Access Type Modify
Read Only
Email mncplaymedia.com Account Name
Other:
BOS Notes
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