"Project Change Request Template" - Maryland

Project Change Request Template is a legal document that was released by the Maryland Department of Information Technology - a government authority operating within Maryland.

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Project Change Request (PCR)
Project Information
Partner Agency Name:
Partner Agency Name
Service Name:
Name of Application / Service
Date Requested:
MM/DD/YYYY
Requested By:
Name and Contact Information
Reason for Change Request
Statutory Requirement
Business Need
Other _______________________________________________________________________________
Description of Change
(Please provide screen shots if necessary as attachments)
Acceptance
This document and any attachments describe the requirements and features identified as changes requested
system. The changes to the system will be accepted as complete when these requirements and features are
implemented.
Agency
Signature:__________________________________________
Date:
____________________
Printed Name:_______________________________________
Title:
____________________
NIC Maryland
Signature:___________________________________________
Date:
____________________
Printed Name:_______________________________________
Title:
NIC Maryland Project Mgr.
Maryland Self-funded eGovernment Services
Contract # 060B1400050
Project Change Request (PCR)
Project Information
Partner Agency Name:
Partner Agency Name
Service Name:
Name of Application / Service
Date Requested:
MM/DD/YYYY
Requested By:
Name and Contact Information
Reason for Change Request
Statutory Requirement
Business Need
Other _______________________________________________________________________________
Description of Change
(Please provide screen shots if necessary as attachments)
Acceptance
This document and any attachments describe the requirements and features identified as changes requested
system. The changes to the system will be accepted as complete when these requirements and features are
implemented.
Agency
Signature:__________________________________________
Date:
____________________
Printed Name:_______________________________________
Title:
____________________
NIC Maryland
Signature:___________________________________________
Date:
____________________
Printed Name:_______________________________________
Title:
NIC Maryland Project Mgr.
Maryland Self-funded eGovernment Services
Contract # 060B1400050