Issue Closure Form
Document and confirm the closure of a resolved issue. Please complete all relevant fields to ensure accurate record keeping.
Issue ID or Reference
*
Issue Title
*
Describe the issue that was resolved
*
Actions Taken to Resolve the Issue
*
Resolution Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Was the issue fully resolved?
*
Yes
No
Additional Comments (optional)
Closed By (Full Name)
*
First Name
Last Name
Confirmation of Closure
*
I confirm that the issue has been resolved and closed.
Signature
*
Submit
Submit
Should be Empty: