Software Application Closure Request Form
Submit this form to request the closure of access to a specific software application for a user or team.
Requestor's Full Name
*
First Name
Last Name
Requestor's Email Address
*
example@example.com
Department
*
Please Select
Human Resources
Finance
IT
Operations
Sales
Marketing
Other
Software Application Name
*
Please Select
SAP
Salesforce
Office 365
Jira
Slack
Other
Username or Account to be Closed
*
Employee/User ID (if applicable)
Reason for Closure
*
Please Select
Employee Departure
Role Change
Security Concern
Application No Longer Needed
Other
Requested Closure Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Has all necessary data been backed up or transferred before closure?
*
Yes
No
Not Applicable
Manager/Supervisor Name
*
First Name
Last Name
Manager/Supervisor Email Address
*
example@example.com
Additional Comments or Instructions
Submit Closure Request
Should be Empty: