User Testing Acceptance Form

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					                                 Information Technology Services
                                 User Acceptance Testing & Signoff

Purpose: The User Acceptance Form is completed immediately following the completion of application
testing and prior to review by the IT Change Advisory Board. The acceptance procedure applies to all
software applications being delivered to business units, which are supported by the Information
Technology Department.         This form serves as the user’s recommendation by the testing
representative(s) for delivery of software release(s) and/or fixes that are migrated to production.

In the event that the change cannot be tested (e.g., lack of a functioning test environment, etc.), this
form will serve as an “Awareness of Change” to systems and validate the user’s acceptance to the
change. Please notate this information in the Approved/Rejected Comments area.

I.     General Information
  System Name: Click here to enter text.                                      Software Release Version:
                                                                              Click here to enter text.
 Description of Requested Change and/or Project Implementation:               Proposed Date:
 Click here to enter text.                                                    Click here to enter a date.

 Proof of Compliance:                                                         Approval:
    User Acceptance Sign-off             Test plans attached                     Accepted
    Work Order                           Transfer report                         Rejected
    Interface Modification Request       Other
    TEST environment not available for testing
                                  To Be Completed by IT Change Manager
 Change ID#                                             Date Approved:

II.   Approved/Rejected Comments:
  Enter a brief summary of the testing process and outcome (if applicable):

                                           Sign-off Authorization
____________________                                     ___________
Authorized Signature of Department Sponsor               Date

Print Your Name and Title

____________________                                     ___________
Authorized Signature of IT Sponsor                       Date

                                                                                                 User Acceptance Form

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Description: This template can be used to obtain business stakholder signoff to system testing