FND-140
Security Authority for TANS Users
User Type
*
Please Select
Organization
Education Service Center
Internal TDA
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Organization Information
ORG ID
*
Name of Organization
*
DBA Name
Delegation of Security Authority
TDA considers the User Access Manager to be the Highest Official within the Organization. The Highest Official does have the option to delegate the User Access Manager responsibility to another employee of the district. The other employee must not be a temporary employee or contractor.
Is the Highest Official delegating the User Access Manager responsibility to another employee (user)?
*
Please Select
Yes
No
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Education Service Center
Region
*
Please Select
Region 1: 1900 West Schunior Edinburg, TX 78541
Region 2: 209 North Water Street Corpus Christi, TX 78401
Region 3: 1905 Leary Lane Victoria, TX 77901
Region 4: 7145 West Tidwell Houston, TX 77092
Region 5: 350 Pine Street, Suite 500 Beaumont, TX 77701
Region 6: 3332 Montgomery Road Huntsville, TX 77340
Region 7: 1909 N. Longview Street Kilgore, TX 75662
Region 8: 4845 U.S. Highway 271 N. Pittsburg, TX 75686
Region 9: 301 Loop 11 Wichita Falls, TX 76306
Region 10: 400 E. Spring Valley Road Richardson, TX. 75081
Region 11: 1451 S. Cherry Lane White Settlement, TX 76108
Region 12: 2101 W. Loop 340, 76712
Region 13: 5701 Springdale Road Austin, TX 78723
Region 14: 1850 Highway 351 Abilene, TX 79601
Region 15: 612 South Irene Street, 76903
Region 16: 5800 Bell Street Amarillo, TX 79109
Region 17: 1111 West Loop 289 Lubbock, TX 79416
Region 18: 2811 LaForce Blvd., 79706
Region 19: 6611 Boeing Drive, 79925
Region 20: 1314 Hines Avenue San Antonio, TX 78208
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User Information
Internal TDA Type
*
Please Select
F&N Staff
Auditor
Information Technology Staff
User status (if applicable)
Contractor
Temporary
User Name
*
Legal First Name (no nicknames authorized)
Legal Last Name
User Position Title
*
User Phone Number
*
Please enter a valid phone number.
User Business Email
*
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Approver Information
For Organization, information should be of the Highest Official of your entity such as Superintendent, President of the Board, etc.
Approver Name
*
Legal First Name
Legal Last Name
Approver Business Email
*
Confirmation Email
Enter the email address again to verify
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Access Request
Organization Request
*
Please Select
Add New Organization User Access Manager
Remove Existing Organization User Access Manager
ESC Request
*
Please Select
Add New ESC Specialist
Remove Existing ESC Specialist
TDA Add
Application Specialist
Claims Specialist
Compliance Specialist
Financial Administrator
ELMS Specialist
Data Specialist
Systems Specialist
Program Read Only
TDA Remove
Application Specialist
Claims Specialist
Compliance Specialist
Financial Administrator
ELMS Specialist
Data Specialist
Systems Specialist
Program Read Only
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Are you replacing the existing Organization User Access Manager
*
Please Select
Yes
No
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Name of the User Access Manager being replaced
*
First Name
Last Name
User Login ID
*
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User Signature
Signature
*
Date
*
-
Month
-
Day
Year
Date
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Submit for Approval
Geo Information
Date (Now)
-
Month
-
Day
Year
Date
Submit
Submit
Should be Empty: