Bank Employee System Access Request Form
Use this form to request internal system access for bank employees. Provide the requested access details, business justification, and manager approval information so IT can review and provision access.
Employee Information
Full Name
*
First Name
Middle Name
Last Name
Work Email
*
example@example.com
Employee / HR Identifier
Department
*
Please Select
Operations
IT
Finance
Human Resources
Risk & Compliance
Customer Service
Other
Job Title / Role
*
Office Location / Branch
*
Please Select
Head Office
Branch Office
Regional Office
Remote
Other
Direct Manager Name
*
First Name
Middle Name
Last Name
Access Request Details
Requested System/Application(s)
*
Core Banking System
Customer Information System
Loan Processing System
Treasury Management System
Wire Transfer Portal
Reporting Dashboard
Other
Requested Access Level / Role
*
Please Select
Viewer
Standard User
Power User
Approver
Administrator
Other
Business Justification
*
Access Start Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Access End Date / Expiration Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Request Type
*
New Access
Change Access
Remove Access
Security and Technical Requirements
Network/VPN access needed?
*
Yes
No
Access mode required
*
Remote access
On-site only
Both
Device type for access
*
Please Select
Company laptop
Desktop workstation
Thin client
Shared workstation
Other
Special privilege or administrative access needed?
*
No
Yes
Additional notes for IT/Security review
Manager Approval and Authorization
Manager Name
*
First Name
Middle Name
Last Name
Manager Email
*
example@example.com
Approval Status
*
Approved
Not Yet Approved
Needs Review
Approval Comments or Conditions
Submit Request
Should be Empty: