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									                                  ICSD-201 REMOTE ACCESS USER AGREEMENT

A. When Used
      This form is used to document the agreement between DAGS/ICSD and the Employee regarding the granting and
      use of remote access to Information Technology Resources under the jurisdiction of ICSD by an ICSD Employee for
      the purposes of call-back problem resolution or scheduled overtime work. It is also used to terminate the

B. General
      This form is initiated by the immediate manager or supervisor of the ICSD person who is to be given remote access.
      The form must be signed by the ICSD Employee prior to proceeding with the tasks necessary to grant remote
      access. Once the Employee has signed the form, it is forwarded to ICSD management for the approval and
      authorization signatures of the appropriate managers.

      After the ICSD Division Administrator signs authorization and approval for remote access, copies of the form are to
      be filed as specified in C. Distribution, below. It is the Requestor’s responsibility to inform the Employee that
      access has been approved or terminated. If the action is to terminate the remote access privileges, the Employee
      is not required to sign the form. For both granting and termination of access privileges, all levels of managers are
      required to sign the form and copies of the form are to be filed as specified in C. Distribution, below.

C. Distribution
                  Original:   ICSD Administration, employee personnel jacket
                  Copies:     Originating Branch
                              Production Systems Branch
                              Systems Services Branch
                              Telecommunications Services Branch

      1. Requestor. The name of the ICSD manager who initiates the request.

      2. BR/SEC. The name of the ICSD branch and section of the person identified in item #1.

      3. Date. The date the request was initiated. Format: mm/dd/yyyy.

      4. Employee. The first name, middle initials, and last name of the ICSD employee for whom remote access
         privileges are to be granted.

      5. VPN/HOD Logonid. The logonid that the employee will be using to set up the VPN tunnel in order to
         remotely access the ICSD systems identified in item #6. i.e. for John J Jones the logonid would be: xjonejj

      6. Access Areas. Check each box for which remote access is to be granted and supply the logonid for the
         system. If a box for a system is checked, a logonid must be entered for that system. If the form is being used
         to terminate privileges, all privileges will be terminated if the Terminate box is the only box that is checked.
         Otherwise, remote access to only those boxes that are checked will be terminated.

      7. Agreement. A list of the criteria and stipulations to which the Employee must agree in order to be granted
         remote access privileges. The employee must sign on the signature line and enter the date that the form was

      8. Approval and Authorization. The ICSD managers approving and authorizing the granting of remote
         access privileges to the ICSD Employee. The Requestor should enter the names of all ICSD managers who
         are needed to approve the remote access agreement. Each manager signs and dates the form then forwards it
         to the next manager for approval.

      9. Reserved for Administrative Use. The name of the person(s) who processed the request, the date that
         the request was completed, and any notes pertinent to the processing.

ICSD-201i (Rev 05/23/2007)

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