Manual Control Assessment Form
Evaluate and document the effectiveness of manual controls within your organization or process.
Assessor Name
*
First Name
Last Name
Assessment Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Department/Process Being Assessed
*
Control Name or Reference
*
Description of Manual Control
*
Objective of the Control
*
Frequency of Control Execution
*
Please Select
Daily
Weekly
Monthly
Quarterly
Annually
Other
Control Owner/Responsible Person
*
Assessment of Control Design and Operation
*
Rows
Control Design Adequacy
Control Operation Effectiveness
Clearly Defined Procedure
1
2
Proper Documentation
3
4
Segregation of Duties
5
6
Timely Execution
7
8
Evidence Retention
9
10
Rate the overall effectiveness of this manual control
*
1
2
3
4
5
Are there any deficiencies or issues identified?
*
No deficiencies identified
Deficiencies identified
If deficiencies were identified, please describe them
Recommendations for Improvement
Additional Comments or Observations
Submit Assessment
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