Exemption+Form+SFN51678.pdf

This document is a North Dakota state government form (SFN 51687, dated 6-2019) titled "Request for Exemption from Information Technology Standards or Statutory Policies" used by state agencies to request an exemption from existing IT standards or policies. The form is issued by the North Dakota Information Technology (NDIT) department and is designed for state agencies to formally document and seek approval for deviations from established information technology guidelines.

The form provides a structured template for agencies to detail the specific exemption being requested, including background justification, potential impacts if the request is denied, and spaces for required signatures from the agency director, ND Chief Information Officer, and potentially the Office of Management and Budget Director. While the specific details of an exemption are not filled out in this blank template, the document serves as an official mechanism for state agencies to transparently request and document exceptions to standard IT protocols, ensuring proper review and authorization by relevant state technology governance entities.