Section 1

Request Information

Agency: Select the Agency that this request is for.

Effective Date: Select the date that this request needs to be processed.

Type of Request:

• New - Select if the request is to create a new zz/aa Admin Account.



• Modify - Select if the request is to update/modify an existing zz/aa Admin Account.



• Disable - Select if the request is to disable/de-activate an existing zz/aa Admin Account. Disabled accounts will be held for 90 days, and then deleted.

Section 2

Employee/Contractor Information

Single or Multiple users:

• Single - Select if the request is for one user.
• Multiple - Select if the request is for more than one user.

• Partnership Employee (VITA/NG) - Select if user is an employee of VITA or Northrop Grumman.



• Agency Employee/Contractor - Select if user is an employee or contractor of an agency within the Commonwealth of Virginia.
  

Section 3

Account Requirements

Access Groups Required?

• If Yes, - Enter the access security groups the user needs to be added to (if this is a modification request) and/or removed from.

• If Yes, - Enter the the Account Model Name and Account Model Email Address of an existing COV account that has the same access/permissions that you want this requested account to have.

Section 4

Other Instructions/Comments

Enter any additional comments in the text box that you feel may assist in the approval and/or the processing of this request.

Section 5

Account Requester Information

“Requester's First Name” through “Requester's Zip” fields - Input your contact information in the fields provided.

Section 6

Agency Authorized Account Request Approver Information

Agency Approver's Email (1-4): Input up to 4 email addresses for your Agency's Authorized Account Request Approvers. Agency Authorized Account Request Approvers consist of AITRs, ISOs, and Designees. When this form is submitted, those individuals listed within these fields will receive an email from you via the COV Account Request Website to approve or deny the request.