Exhibit_L_-_VPN_Request_Form_Fillable.pdf
PDF 263 KB Posted
- Solicitation number
- 2023-GEN-0276
- Issued by
- Sacramento County, San Francisco City, California
About this file
This document is a VPN Account Request Form from the Sacramento County Department of Technology, published on 7/01/2014. The form is designed for adding, modifying, or deleting remote access accounts for third-party users. It requires detailed information about the person utilizing the remote access account, including their name, business phone, email, employer, and business address. The form also requires an approving authority (sponsoring entity) to provide their contact information and specify the services and resource access required.
The form emphasizes important security considerations, noting that virus protection software and a personal firewall are strongly recommended but not provided by the county. Users must acknowledge the risk of installing the Remote Access client, which might adversely affect other applications on their PC. The request requires a signed Security Responsibility form to be submitted along with the VPN Account Request Form to the DTech Remote Access team via email. The form is version 2.0 and provides clear instructions for submitting changes to existing remote access accounts, such as updates to contact information.
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Text version
Department of Technology Published: 7/01/2014 Third Party Remote Access Service Request Version 2.0
This request is to (Check One):
Add/Modify Delete
Remote Access account.
To change name, address, phone or email information for a User that already has Remote Access connectivity, no form is required. Just submit the following:
An email from the Sponsoring Agent to RemoteAccessTeam@SacCounty.net containing:
User’s Remote Access User ID
Old Information
New (changed) Information
PERSON UTILIZING REMOTE ACCESS ACCOUNT
Name: Business Phone:
Business Email: Remote Access User ID*:
Employer:
Business Address:
* Assigned by DTECH
APPROVING AUTHORITY (SPONSORING ENTITY)
Name (Manager or above): Business Phone:
Business Email:
Virus protection software and a personal firewall product will not be provided, but both are strongly recommended.
SERVICES REQUIRED OR COMMENTS (SPONSORING ENTITY)
Please detail services and resource access required. You may also provide details regarding requested restrictions (if any), comments, or other pertinent information :
IMPORTANT INFORMATION
By installing the Remote Access client on your PC, you are assuming the risk and responsibility that the Remote Access client might adversely affect other applications on your PC. Prior to installing the Remote Access client, you should ensure that other applications you are running will not be adversely affected, as the County is not responsible for any such adverse effects.
The signed form must be delivered to the DTech Remote Access team.
A Security Responsibility form signed by the user must be returned to the DTech Remote Access team with this form.
Save a copy of this form and send it to remoteaccessteam@saccounty.net
Department of Technology
VPN ACCOUNT REQUEST FORM
Exhibit L
| AddModify: Off |
| Delete: Off |
| Name: |
| Business Phone: |
| Business Email: |
| Remote Access User ID: |
| Employer: |
| Business Address: |
| Name Manager or above: |
| Business Phone_2: |
| Business Email_2: |
| Please detail services and resource access required You may also provide details regarding requested restrictions if any comments or other pertinent information: |
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