This Approval Request Form (the “Form”) is submitted on [Submission Date] by [Requester Name].
1. Request Overview
1.1 Request Title. [Short descriptive title].
1.2 Request Type.
☐ Purchase/Spend Approval
☐ Vendor/Tool Approval
☐ Contract/Legal Approval
☐ Policy Exception
☐ Security/IT Change
☐ Access Request
☐ Other: [Describe]
1.3 Department/Team. [Team/Department].
1.4 Priority. ☐ Low ☐ Medium ☐ High ☐ Urgent.
1.5 Decision Needed By. [Date].
2. Request Details
2.1 Description of Request. [What you want approved, in plain language].
2.2 Business Justification. [Why it’s needed and what problem it solves].
2.3 Scope.
-
In scope: [What’s included]
-
Out of scope: [What’s excluded]
2.4 Owner/Responsible Person. [Name and role].
2.5 Impact if Not Approved. [What happens if denied or delayed].
In scope: [What’s included]
Out of scope: [What’s excluded]
2.4 Owner/Responsible Person. [Name and role].
2.5 Impact if Not Approved. [What happens if denied or delayed].
3. Cost and Budget
3.1 Total Cost. $[Amount] (estimate or quote).
3.2 Cost Breakdown (Optional). [One-time fees, monthly fees, implementation costs].
3.3 Budget Owner. [Name/Department].
3.4 Payment Timing. ☐ One-time ☐ Monthly ☐ Annual ☐ Other: [Timing].
3.5 Vendor/Payee (If Applicable). [Vendor name].
3.6 Procurement Needed. ☐ Yes ☐ No ☐ Not sure.
4. Risk, Compliance, and Security
4.1 Risk Summary. [Key risks in plain language].
4.2 Security Impact.
☐ No security impact
☐ Low impact
☐ Moderate impact
☐ High impact
Details: [Describe].
4.3 Compliance/Legal Impact.
☐ No compliance impact
☐ Policy exception requested
☐ Contract review needed
☐ Data privacy considerations
Details: [Describe].
4.4 Mitigation Plan. [How you will reduce or manage risks].
4.5 Dependencies. [Other teams, approvals, systems, timelines].
5. Alternatives Considered
5.1 Alternatives. [Other options evaluated].
5.2 Why This Option. [Why the selected option is best].
6. Implementation Plan
6.1 Proposed Start Date. [Date].
6.2 Proposed End Date. [Date].
6.3 Key Steps.
Step 1: [Action]
Step 2: [Action]
Step 3: [Action]
6.4 Success Criteria. [How success will be measured].
6.5 Rollback Plan (If Applicable). [How to undo/stop if needed].
7. Attachments
7.1 Supporting Documents Attached.
☐ Quote/Estimate
☐ Contract / Terms
☐ Security review or questionnaire
☐ Architecture diagram
☐ Risk assessment
☐ Other: [List]
8. Approvals
8.1 Decision.
☐ Approved
☐ Approved with conditions: [Conditions]
☐ Not approved
☐ More information needed: [Requested info]
8.2 Approver Notes. [Notes].
9. Signatures
Requester Name: [Name]
Title/Role: [Title]
Date: [Date]
Signature: ___________________________
Approver 1: [Name]
Title/Role: [Title]
Date: [Date]
Signature: ___________________________
Approver 2 (Optional): [Name]
Title/Role: [Title]
Date: [Date]
Signature: ___________________________
Approver 3 (Optional): [Name]
Title/Role: [Title]
Date: [Date]
Signature: ___________________________