Change Request (Cr) Form Page 2

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Business Unit (Signature Required)
Requested by:
Date:
Approved by:
Date:
(Business Unit-Manager level or above)
Committees (Optional)
Reviewed by: [Committee Name]
Date:
Approved by: [Committee Signatory]
Date:
Reviewed by: [Committee Name]
Date:
Approved by: [Committee Signatory]
Date:
Software Development Team (Signature Required)
Use Case Reviewed by:
Date:
(Use Case Completed and Attached)
Approved by: [Manager Name]
Date:
(Manager level or above)
Development & Quality Assurance
Estimated effort to create the CR:
Hours:
Projected Pre-Test Completion Date:
Date:
Projected Date QA Completed:
Date:
(unit, integration, black box, stress & beta – tests not planed are struck through
)
Customer Acceptance & Deployment
Customer Acceptance:
Date:
Application Version Assigned:
Version:
Planed Release Date:
Date:
Notes:
Created by [Analyst Name]
Document Version: 1.0
Created on 7/20/2015 11:27:00 PM
Last printed 7/23/2015 11:29:00 AM
Document Location: C:\dexform\good_results\xml\nolinks\250040.xml

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