State Form 38410 - Information Processing Form Page 2
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1
2STATE OF INDIANA - Information Processing
PROJECT
STEP 3
Policy and Management Procedures
PRELIMINARY DESIGN
Page 2 of 2
I. Requesting Agency:
J. Project Number:
K. Resource Requirements
Prepare
Prepare
Step 3
Step 3
Implement
Operate
System
System
(EST.)
(Actual)
1. Agency Cost
- Personnel
- Equipment & Software
- Contract Services
- Miscellaneous
- Total Agency Costs
2. Division of Information Technology Costs
- Development and
Programming Services
- Processing Services
- Dedicated Facilities
- Total Information
Services Division Costs
3. Total Cost
4. Total Project Cost (Using Actual Costs to Prepare Step 3):
5. (Check All Applicable to any Project Phase Through First Full Year
of Operation):
Additional Budget Request
Additional Personnel Request
Non-State Funds to be Used
State Match Required
Additional Equipment Req’d
Part or All to be Contracted
L. Proposed By:
Agency Account Number
Agency Project Manager
Date
System Development Manager
Date
M. Approvals:
Agency Head:
Auditor - State Board of Accounts:
Budget Analyst*:
Executive Director - OST*:
DPOC Chairman*:
Name
Date
(* if required)
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Parent category: Legal