CORE Change / Interface Request Form
Email address *
Request Description / Short Name *
Your answer
Agency Name / CORE Dept Code *
Your answer
Agency Contact Name /Position *
Your answer
Agency Contact e-mail *
Your answer
Change Description (Narrative of what is requested to be changed.) *
Your answer
Request Category *
Request Severity Type *
Technical Justification For Change Request *
Your answer
Impact of Not Making The Change *
Your answer
Internal Controls (Current and Proposed)
Your answer
Completion Date Requested, and Reason Why *
MM
/
DD
/
YYYY
Please explain why the above date was selected: *
Your answer
Additional questions to be completed ONLY if requesting net new or change in existing CORE interface
Complete the following sections ONLY of your CORE modification involves a new or change in existing interface
Name of System to be Interfaced with CORE
Your answer
Please describe the reason and file type(s) the department would like interface into CORE
Your answer
What is the current process to get this information into CORE?
Your answer
What are the internal controls (and lack of controls) of the current process?
Your answer
Does your agency intend to have these documents submitted to CORE in draft or approved? (standard practice is approved) If in draft, please explain.
Your answer
How does the department envision the internal controls for the new process (and any other processes that may be impacted)
Your answer
When is the desired date for the interface to be active in production?
MM
/
DD
/
YYYY
How often will this interface occur?
Your answer
How many files / batches of files will be in each interface?
Your answer
Will there be any impact to reporting (InfoAdvantage)?
Your answer
Please use this section to list any other relevant information in regards to this request (not just interfaces, any additional info).
Your answer
Additional Info continued......
Your answer
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