Exception Request Form
Complete Exception Form
Gather all necessary details related to the exception.
Form Completion Date
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Month
-
Day
Year
Date
Requester's Name
First Name
Last Name
Department
Position/Title
Email
example@example.com
In which systems is action is taken place? (e.g, firewall, webserver, operating system , etc.)
Which Security Policy/Standard is being deviated from?
Exception Domain
Details of Requested Change e.g. Going live with a service without hardening OS.
What is your risk mitigation plan?
Explain the risk of implementing this change. (e.g. The web portal will be accessible to the public which could results in a data breach.)
What will happen if the request is denied? How will it affect the products and services?
Approval Section
Cyber Security Approval
This section should be completed by Cyber Security Team.
Approver's Name
First Name
Last Name
Policy Alignment Check
Risk Severity
Please Select
High
Medium
Low
Decision
Approved
Denied
Ongoing
Decision justification
Date of Approved/Denied
-
Month
-
Day
Year
Date
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