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<br />RSA CORP I business I technology ,lJl <br /> <br /> <br />P.O. Box 890646 I Houston, TX 77289 I 281.488.7961 I www.RSAcorp.comlinfo@RSAcorp.com <br /> <br />Appendix A - RSA Service Change Request (SCR) # <br /> <br />Project: <br /> <br />Performed under PSA# <br /> <br />Client: <br /> <br />Date: <br /> <br />Requested by: <br /> <br />Telephone Numbt'r: _ <br /> <br />Nature of the proposed change: <br /> <br />I <br /> <br />Reasons for the change: <br /> <br />I <br /> <br />Potential Risl,s: <br /> <br />I <br /> <br />Risk Mitigation/Change Back-out Plan: <br /> <br />I <br /> <br />I mpact of change on project: <br /> <br />I <br /> <br />Nature of the proposed change: <br /> <br />I <br /> <br />Estimated Honrs: <br /> <br />Estimated Pricing: <br /> <br />Schednle Changes: <br /> <br />I <br /> <br />This Service Change Request is: Approved D <br /> <br />ReJected 0 <br /> <br />Heason(s) for Non-App,'oval: <br /> <br />I <br /> <br />Signatures: <br /> <br />RSA Project Sponsor: Date: <br /> <br />Client ProJect Sponsor: _ Date: <br /> <br />Ycur P~~i"1ner h:-)l'" !T Services & Staffino. Visit our 0109 at www.PartnerIT.com. <br />