<table style="width:100%;">
<colgroup>
<col style="width: 7%" />
<col style="width: 2%" />
<col style="width: 5%" />
<col style="width: 8%" />
<col style="width: 9%" />
<col style="width: 16%" />
<col style="width: 0%" />
<col style="width: 8%" />
<col style="width: 2%" />
<col style="width: 7%" />
<col style="width: 6%" />
<col style="width: 0%" />
<col style="width: 7%" />
<col style="width: 17%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="8" rowspan="10"><p><strong>AD-1143 U. S. DEPARTMENT OF
AGRICULTURE</strong></p>
<p><strong>CORPORATE SYSTEMS ACCESS REQUEST FORM</strong></p></td>
<td colspan="6"><p><strong>1.</strong> SYSTEM/APPLICATION NAME</p>
<p>Check one or more and complete the applicable section(s)</p>
<p>the applicable section(s))</p></td>
</tr>
<tr class="even">
<td> </td>
<td colspan="5">Automated Cash Reconciliation Worksheet System</td>
</tr>
<tr class="odd">
<td> </td>
<td colspan="5">Corporate Property Automated Information System</td>
</tr>
<tr class="even">
<td> </td>
<td colspan="5">Financial Data Warehouse</td>
</tr>
<tr class="odd">
<td> </td>
<td colspan="5"><p>Foundation Financial Information System</p>
<p>FFIS</p></td>
</tr>
<tr class="even">
<td> </td>
<td colspan="5">GovTrip.com</td>
</tr>
<tr class="odd">
<td> </td>
<td colspan="5">Integrated Acquisition System</td>
</tr>
<tr class="even">
<td> </td>
<td colspan="5">Management Initiatives Tracking System</td>
</tr>
<tr class="odd">
<td> </td>
<td colspan="5">Secure Remote</td>
</tr>
<tr class="even">
<td colspan="6"><table>
<colgroup>
<col style="width: 5%" />
<col style="width: 94%" />
</colgroup>
<tbody>
<tr class="odd">
<td> </td>
<td>FedTraveler.com</td>
</tr>
<tr class="even">
<td> </td>
<td>Remedy Support</td>
</tr>
</tbody>
</table>
<p><strong>2.</strong> FFIS APPLICATION NUMBER(S) (If
Applicable)</p></td>
</tr>
<tr class="odd">
<td colspan="14"><p><strong>USER INFORMATION <em>(See Privacy Act
Statement)</em></strong></p>
<h1 id="u">U</h1></td>
</tr>
<tr class="even">
<td colspan="4"><strong>3.</strong> USER’S SSN (See Instructions)</td>
<td colspan="8"><strong>4.</strong> USER’S NAME <em>(Last, first, middle
initial)</em></td>
<td colspan="2"><strong>5.</strong> USER’S TITLE OR
CONTRACTOR<strong>*</strong></td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="8"></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="10"><strong>6.</strong> USER’S MAILING ADDRESS WITH ZIP
CODE</td>
<td colspan="3"><strong>7.</strong> AGENCY</td>
<td><strong>8.</strong> OFFICE</td>
</tr>
<tr class="odd">
<td colspan="6"><strong>9.</strong> USER’S E-MAIL ADDRESS</td>
<td colspan="5" rowspan="2"><p><strong>10.</strong> USER’S PHONE
NUMBER</p>
<p>(<strong>   </strong>)-   -    </p></td>
<td colspan="3" rowspan="2"><p><strong>11.</strong> MANAGER’S PHONE
NUMBER</p>
<p>(<strong>   </strong>)-   -    </p></td>
</tr>
<tr class="even">
<td colspan="6"></td>
</tr>
<tr class="odd">
<td colspan="14"><em>*See special instructions</em></td>
</tr>
<tr class="even">
<td colspan="14"><h1 id="action-requested">ACTION REQUESTED</h1>
<h1 id="u-1">U</h1></td>
</tr>
<tr class="odd">
<td colspan="3" rowspan="2"><strong>NAME CHANGE</strong></td>
<td colspan="3"><strong>12.</strong> OLD NAME <em>(Last, first, middle
initial)</em></td>
<td colspan="8"><strong>13.</strong> NEW NAME <em>(Last, first, middle
initial)</em></td>
</tr>
<tr class="even">
<td colspan="3"></td>
<td colspan="8"></td>
</tr>
<tr class="odd">
<td rowspan="5"><h2 id="access">ACCESS</h2></td>
<td colspan="5"><strong>14.</strong> (Check all that apply):</td>
<td colspan="8" rowspan="5"><strong>15.</strong> USER ID(S) (Include
NFC, FFIS, E-Auth User ID, if applicable)</td>
</tr>
<tr class="even">
<td> </td>
<td colspan="4">Add User</td>
</tr>
<tr class="odd">
<td> </td>
<td colspan="4">Delete User</td>
</tr>
<tr class="even">
<td> </td>
<td colspan="4">Modify User Profile</td>
</tr>
<tr class="odd">
<td> </td>
<td colspan="4">Agency Cross-Service Access</td>
</tr>
<tr class="even">
<td colspan="14"><h1 id="section"></h1></td>
</tr>
<tr class="odd">
<td colspan="14"><h1
id="automated-cash-reconciliation-worksheet-system-acrws-access">AUTOMATED
CASH RECONCILIATION WORKSHEET SYSTEM (ACRWS) ACCESS</h1></td>
</tr>
<tr class="even">
<td colspan="5"><p><strong>16.</strong> USER’S ACRWS 52 Roles/Access</p>
<p>(Check all that apply)</p>
<p> Public/Read-Only</p>
<p> Auditor</p>
<p> Approver</p>
<p> Import Manager</p>
<p> ACRWS 52BRIO/Hyperion</p></td>
<td></td>
<td colspan="8"><p><strong>17.</strong> USER’S ACRWS 53 Roles/Access</p>
<p>(Check all that apply)</p>
<p> Public/Read-Only</p>
<p> Auditor</p>
<p> Approver</p>
<p> Import Manager</p>
<p> ACRWS 53 BRIO/Hyperion</p></td>
</tr>
<tr class="odd">
<td colspan="14"><h1 id="section-1"></h1></td>
</tr>
<tr class="even">
<td colspan="14"><h1
id="corporate-property-automated-information-system-cpais-access">CORPORATE
PROPERTY AUTOMATED INFORMATION SYSTEM (CPAIS) ACCESS</h1></td>
</tr>
<tr class="odd">
<td colspan="14"><p><strong>19.</strong> USER’S CPAIS ROLE</p>
<p> UMA Manager</p>
<h1 id="section-2"></h1></td>
</tr>
<tr class="even">
<td colspan="7"><p><strong>20.</strong> CPAIS TRAINING RECEIVED? (If
yes, enter date completed)</p>
<h1 id="yes-no"> Yes No</h1></td>
<td colspan="7"><p><strong>21.</strong> SIGNATURE OF AUTHORIZED APPROVER
(Sign when action has been completed)</p>
<h1 id="section-3"></h1></td>
</tr>
</tbody>
</table>

+-----------------------+-----------+-----------+-----------------------+
| # FINANCIAL DATA W    |           |           |                       |
| AREHOUSE (FDW) ACCESS |           |           |                       |
+-----------------------+-----------+-----------+-----------------------+
| **25.** USER'S        |           | **26.**   |                       |
| SECURITY GROUP        |           | USER'S    |                       |
|                       |           | SECURITY  |                       |
| Payroll Security      |           | ACCESS    |                       |
|                       |           |           |                       |
| Non-Payroll           |           | Basic     |                       |
|                       |           | User,     |                       |
|                       |           | Canned    |                       |
|                       |           | Reports   |                       |
|                       |           |           |                       |
|                       |           | Power     |                       |
|                       |           | User, Ad  |                       |
|                       |           | hoc       |                       |
|                       |           | Queries   |                       |
|                       |           |           |                       |
|                       |           | #  {#s    |                       |
|                       |           | ection-4} |                       |
+-----------------------+-----------+-----------+-----------------------+
| #  {#section-5}       |           |           |                       |
+-----------------------+-----------+-----------+-----------------------+
| #                     |           |           |                       |
| INTEGRATED ACQUISITIO |           |           |                       |
| N SYSTEM (IAS) ACCESS |           |           |                       |
+-----------------------+-----------+-----------+-----------------------+
| **28.** USER'S IAS    | Receiver  |           | **29.** REQUISITION   |
| ROLE (Check all that  |           |           | APPROVAL AMOUNT       |
| apply)                | Invoice   |           |                       |
|                       | Entry     |           |                       |
| Requisitioner         | Clerk     |           |                       |
|                       |           |           |                       |
| Requisition Approver  | Payment   |           |                       |
|                       | Approving |           |                       |
| Budget Approver       | Officer   |           |                       |
|                       |           |           |                       |
| Commitment Error      | Payment   |           |                       |
| Manager               | Approving |           |                       |
|                       | Error     |           |                       |
| Purchasing            | Manager   |           |                       |
| S                     |           |           |                       |
| pecialist/Contracting | Interface |           |                       |
| Officer               | Manager   |           |                       |
|                       |           |           |                       |
| Supervisory           | #  Payme  |           |                       |
| Contracting Officer   | nt Status |           |                       |
|                       |  Reviewer |           |                       |
| #  Obl                |           |           |                       |
| igation Error Manager | #         |           |                       |
|                       |   Other \ |           |                       |
|                       | _\_\_\_\_ |           |                       |
|                       | \_\_\_\_\ |           |                       |
|                       | _\_\_\_\_ |           |                       |
|                       | \_\_\_\_\ |           |                       |
|                       | _\_\_\_\_ |           |                       |
|                       | \_\_\_\_\ |           |                       |
|                       | _\_\_\_\_ |           |                       |
+-----------------------+-----------+-----------+-----------------------+
|                       |           |           | **30.** ACQUISITION   |
|                       |           |           | WARRANT AMOUNT        |
+-----------------------+-----------+-----------+-----------------------+
|                       |           |           | **31.** CROSS AGENCY  |
|                       |           |           | SERVICE TO (If        |
|                       |           |           | Applicable)           |
+-----------------------+-----------+-----------+-----------------------+
| #  {#section-6}       |           |           |                       |
+-----------------------+-----------+-----------+-----------------------+
| # MANAGEMENT          |           |           |                       |
|  INITIATIVES TRACKING |           |           |                       |
|  SYSTEM (MITS) ACCESS |           |           |                       |
+-----------------------+-----------+-----------+-----------------------+
| **32.** PMA ROLES     | PART      |           | BUDGET ROLES (Check   |
| (Check one)           | ROLES     |           | one)                  |
|                       | (Check    |           |                       |
| Agency User           | one)      |           | ##  Agency User       |
|                       |           |           |                       |
| Approving Official    | Agency    |           | Approving Official    |
|                       | User      |           |                       |
| Initiative Owner      |           |           | Executive Officer     |
|                       | Approving |           |                       |
| Executive Officer     | Official  |           | OBPA Coordinator      |
|                       |           |           |                       |
| PMA Coordinator       | Mission   |           | Agency(s):            |
|                       | Area      |           | \_\_\_\_\_\_\_\_\_    |
| PMA Initiative(s):    | Co        |           | \_\_\_\_\_\_\_\_\_\_\ |
| \_\_\_\_              | ordinator |           | _\_\_\_\_\_\_\_\_\_\_ |
| \_\_\_\_\_\_\_\_\_\_\ |           |           |                       |
| _\_\_\_\_\_\_\_\_\_\_ | Executive |           |                       |
|                       | Officer   |           |                       |
| \_\_\_\_\_\_          |           |           |                       |
| \_\_\_\_\_\_\_\_\_\_\ | OBPA      |           |                       |
| _\_\_\_\_\_\_\_\_\_\_ | Officer   |           |                       |
|                       |           |           |                       |
| Agency(s):            | PART      |           |                       |
| **\_\_\_\             | Pr        |           |                       |
| _\_\_\_\_\_\_\_\_\_\_ | ogram(s): |           |                       |
| \_\_\_\_\_\_\_\_\_\_\ | \_\_\     |           |                       |
| _\_\_\_\_\_\_\_\_\_** | _\_\_\_\_ |           |                       |
|                       | \_\_\_\_\ |           |                       |
|                       | _\_\_\_\_ |           |                       |
|                       | \_\_\_\_\ |           |                       |
|                       | _\_\_\_\_ |           |                       |
|                       |           |           |                       |
|                       | (         |           |                       |
|                       | Optional) |           |                       |
|                       |           |           |                       |
|                       | \_\_\_\   |           |                       |
|                       | _\_\_\_\_ |           |                       |
|                       | \_\_\_\_\ |           |                       |
|                       | _\_\_\_\_ |           |                       |
|                       | \_\_\_\_\ |           |                       |
|                       | _\_\_\_\_ |           |                       |
|                       |           |           |                       |
|                       | A         |           |                       |
|                       | gency(s): |           |                       |
|                       | **\_\_\_\ |           |                       |
|                       | _\_\_\_\_ |           |                       |
|                       | \_\_\_\_\ |           |                       |
|                       | _\_\_\_\_ |           |                       |
|                       | \_\_\_\_\ |           |                       |
|                       | _\_\_\_\_ |           |                       |
|                       | \_\_\_\_\ |           |                       |
|                       | _\_\_\_** |           |                       |
|                       |           |           |                       |
|                       | Mission   |           |                       |
|                       | Area(s):  |           |                       |
|                       | **\_\_\_  |           |                       |
|                       | \_\_\_\_\ |           |                       |
|                       | _\_\_\_\_ |           |                       |
|                       | \_\_\_\_\ |           |                       |
|                       | _\_\_\_\_ |           |                       |
|                       | \_\_\_\_\ |           |                       |
|                       | _\_\_\_** |           |                       |
|                       |           |           |                       |
|                       | (Required |           |                       |
|                       | for       |           |                       |
|                       | Mission   |           |                       |
|                       | Area      |           |                       |
|                       | Co        |           |                       |
|                       | ordinator |           |                       |
|                       | only)     |           |                       |
+-----------------------+-----------+-----------+-----------------------+

+-----------------------+-----------------------+-----------------------+
| # MANAGEMENT          |                       |                       |
|  INITIATIVES TRACKING |                       |                       |
|  SYSTEM (MITS) ACCESS |                       |                       |
+-----------------------+-----------------------+-----------------------+
| AUDIT TRACKING (Check |                       |                       |
| one)                  |                       |                       |
|                       |                       |                       |
| Agency User           |                       |                       |
|                       |                       |                       |
| Executive Officer and |                       |                       |
| OIG Auditors          |                       |                       |
|                       |                       |                       |
| Audit Follow-up       |                       |                       |
| Coordinator           |                       |                       |
|                       |                       |                       |
| Agency(s):            |                       |                       |
| **\_\_\_\             |                       |                       |
| _\_\_\_\_\_\_\_\_\_\_ |                       |                       |
| \_\_\_\_\_\_\_\_\_\_\ |                       |                       |
| _\_\_\_\_\_\_\_\_\_** |                       |                       |
|                       |                       |                       |
| Mission Area(s):      |                       |                       |
| **\_\_\_\_\_\_\_\_\_  |                       |                       |
| \_\_\_\_\_\_\_\_\_\_\ |                       |                       |
| _\_\_\_\_\_\_\_\_\_** |                       |                       |
+-----------------------+-----------------------+-----------------------+

+-----------------------+-----------------------+-----------------------+
| # GOVTRIP.COM         |                       |                       |
+-----------------------+-----------------------+-----------------------+
| > **33. GovTrip.com   | > **34.** GovTrip     | **35.** GovTrip       |
| > Role**              | > TRAINING RECEIVED?  | Agency APPROVER       |
| >                     | >                     |                       |
| > Traveler            | > (If yes, enter date | (Sign and date when   |
| >                     | > completed)          | action has been       |
| > Travel Arranger     |                       | completed)            |
| >                     | ##                    |                       |
| > Approver            |   Yes  No {#yes-no-1} | Approver:             |
| >                     |                       | \_\_\_\_\_\_          |
| > Agency FATA         | #  {#section-7}       | \_\_\_\_\_\_\_\_\_\_\ |
|                       |                       | _\_\_\_\_\_\_\_\_\_\_ |
|                       | > Date:               |                       |
|                       | > \_\_\_\_\_\_\_\     | Date:                 |
|                       | _\_\_\_\_\_\_\_\_\_\_ | \_\_\_\_\_\_\_\       |
|                       |                       | _\_\_\_\_\_\_\_\_\_\_ |
+-----------------------+-----------------------+-----------------------+

+-----------------------------------------------------------------------+
| # SPECIAL INSTRUCTIONS                                                |
+-----------------------------------------------------------------------+

#  36. SPECIAL INSTRUCTIONS

+---+--------+------------+----+-----+-----------------+----------------+
|   |        |            |    |     |                 |                |
+---+--------+------------+----+-----+-----------------+----------------+
| * |        |            |    |     |                 |                |
| * |        |            |    |     |                 |                |
| U |        |            |    |     |                 |                |
| S |        |            |    |     |                 |                |
| E |        |            |    |     |                 |                |
| R |        |            |    |     |                 |                |
| A |        |            |    |     |                 |                |
| C |        |            |    |     |                 |                |
| K |        |            |    |     |                 |                |
| N |        |            |    |     |                 |                |
| O |        |            |    |     |                 |                |
| W |        |            |    |     |                 |                |
| L |        |            |    |     |                 |                |
| E |        |            |    |     |                 |                |
| D |        |            |    |     |                 |                |
| G |        |            |    |     |                 |                |
| E |        |            |    |     |                 |                |
| M |        |            |    |     |                 |                |
| E |        |            |    |     |                 |                |
| N |        |            |    |     |                 |                |
| T |        |            |    |     |                 |                |
| * |        |            |    |     |                 |                |
| * |        |            |    |     |                 |                |
|   |        |            |    |     |                 |                |
| # |        |            |    |     |                 |                |
|   |        |            |    |     |                 |                |
| * |        |            |    |     |                 |                |
| I |        |            |    |     |                 |                |
|   |        |            |    |     |                 |                |
| h |        |            |    |     |                 |                |
| a |        |            |    |     |                 |                |
| v |        |            |    |     |                 |                |
| e |        |            |    |     |                 |                |
|   |        |            |    |     |                 |                |
| r |        |            |    |     |                 |                |
| e |        |            |    |     |                 |                |
| a |        |            |    |     |                 |                |
| d |        |            |    |     |                 |                |
|   |        |            |    |     |                 |                |
| t |        |            |    |     |                 |                |
| h |        |            |    |     |                 |                |
| e |        |            |    |     |                 |                |
|   |        |            |    |     |                 |                |
| a |        |            |    |     |                 |                |
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| t |        |            |    |     |                 |                |
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| a |        |            |    |     |                 |                |
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| d |        |            |    |     |                 |                |
|   |        |            |    |     |                 |                |
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| f |        |            |    |     |                 |                |
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|   |        |            |    |     |                 |                |
| s |        |            |    |     |                 |                |
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| s |        |            |    |     |                 |                |
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| s |        |            |    |     |                 |                |
|   |        |            |    |     |                 |                |
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| c |        |            |    |     |                 |                |
| u |        |            |    |     |                 |                |
| r |        |            |    |     |                 |                |
| i |        |            |    |     |                 |                |
| t |        |            |    |     |                 |                |
| y |        |            |    |     |                 |                |
|   |        |            |    |     |                 |                |
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| l |        |            |    |     |                 |                |
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| s |        |            |    |     |                 |                |
|   |        |            |    |     |                 |                |
| a |        |            |    |     |                 |                |
| n |        |            |    |     |                 |                |
| d |        |            |    |     |                 |                |
|   |        |            |    |     |                 |                |
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| n |        |            |    |     |                 |                |
| d |        |            |    |     |                 |                |
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| r |        |            |    |     |                 |                |
| s |        |            |    |     |                 |                |
| t |        |            |    |     |                 |                |
| a |        |            |    |     |                 |                |
| n |        |            |    |     |                 |                |
| d |        |            |    |     |                 |                |
|   |        |            |    |     |                 |                |
| t |        |            |    |     |                 |                |
| h |        |            |    |     |                 |                |
| e |        |            |    |     |                 |                |
|   |        |            |    |     |                 |                |
| s |        |            |    |     |                 |                |
| e |        |            |    |     |                 |                |
| c |        |            |    |     |                 |                |
| u |        |            |    |     |                 |                |
| r |        |            |    |     |                 |                |
| i |        |            |    |     |                 |                |
| t |        |            |    |     |                 |                |
| y |        |            |    |     |                 |                |
|   |        |            |    |     |                 |                |
| r |        |            |    |     |                 |                |
| e |        |            |    |     |                 |                |
| q |        |            |    |     |                 |                |
| u |        |            |    |     |                 |                |
| i |        |            |    |     |                 |                |
| r |        |            |    |     |                 |                |
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|   |        |            |    |     |                 |                |
| o |        |            |    |     |                 |                |
| f |        |            |    |     |                 |                |
|   |        |            |    |     |                 |                |
| t |        |            |    |     |                 |                |
| h |        |            |    |     |                 |                |
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|   |        |            |    |     |                 |                |
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| m |        |            |    |     |                 |                |
| a |        |            |    |     |                 |                |
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| d |        |            |    |     |                 |                |
|   |        |            |    |     |                 |                |
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| a |        |            |    |     |                 |                |
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+---+--------+------------+----+-----+-----------------+----------------+

### CORPORATE SYSTEMS ACCESS REQUEST FORM

### SECURITY RULES

1\. **DO NOT ACCESS**, research, or change any account, file, record or
application not required to perform your official duties. You are
forbidden to

access your own account, that of a spouse, relative, friend, neighbor,
or any account in which you have a personal or financial interest. If
you are assigned to work on one of these accounts contact your
supervisor. Behave in an ethical, technically proficient, informed, and
trustworthy manner.

2.  If you are asked by another person to access an account or other
    sensitive or private information, **VERIFY** that the requested
    access is authorized. You will be held responsible if the access is
    not authorized. As a general rule, you should not use a computer or
    terminal in behalf of another person.

3\. **DIFFERENTIATE TASKS AND FUNCTIONS** to ensure that no one person
has sole access to or control over important resources.

4\. **PROTECT YOUR PASSWORD** from disclosure. You are responsible for
any computer activity associated with your password**. DO NOT SHARE**

your password with others or reveal it to anyone, regardless of his/her
position in or outside the USDA. **DO NOT POST** your password in your

work area. **DO NOT USE** another person's password. USER Ids must be
treated with the same care as your password. Everything done with your
user ID or password will be recorded as being done by you. Use unique
passwords for each system and application you access. NEVER give your
password out over the telephone. Be alert to others who may try to
obtain your password. Social engineering is a practice used when hackers
pose as system administrators. A hacker may randomly call a user and say
that something is wrong on the system to get arbitrary access to your
system. They may tell you that they need your password in order to issue
an new one. Always remember that system administrators DO NOT need your
password in order to issue you a new password. Do not re-cycle passwords
by using just a few over and over again, or make minor changes to
passwords by adding a number to the base password.

5\. **PASSWORD DISTRIBUTION AND REFRESHMENT** must be done securely.

6\. **CHANGE YOUR PASSWORD** if you think someone else knows your
password. Immediately notify your supervisor or your Functional Security
Coordinator or Security Representative. Passwords for FFIS, IAS and the
FFIS Data Warehouse will be changed every 30 days as prompted by the
system.

7.  **DO NOT PROGRAM** your login or password into automatic script
    routines or programs.

8.  **LOG OFF/SIGN OFF** if you go to lunch, or break, or anytime you
    leave your computer or terminal.

9.  **PROTECT** your system against viruses and similar malicious
    programs. Make certain that updates to desktop virus protection
    schemes are performed in a timely manner in accordance with vendor
    or system administration instructions.

10. **FOR ADDITIONAL** security, use personnel firewall applications and
    do not allow applications not known to you through the firewall.

11. **PARTICIPATE** in organization-wide security training as required
    and read and adhere to security information pertaining to system
    hardware and software.

12\. **RETRIEVE ALL** hard copy printouts in a timely manner. If you
cannot determine the originator or receiver of a printout, dispose of it
in a burn

waste container or shredder. Store hardcopy reports and storage media
containing confidential information in a locked room or cabinet.

13\. **IDENTIFY ALL** sensitive applications or data that you will be
placing on a system, and any equipment processing sensitive information
to your

supervisor, so that appropriate security measures can be implemented.

14\. **DO NOT USE USDA COMPUTERS** or software for personal use.

15\. **DO NOT USE PERSONAL EQUIPMENT** or software for official business
without your supervisor's written approval.

16\. **DO NOT INSTALL OR USE UNAUTHORIZED SOFTWARE** on USDA equipment.
Do not use freeware, shareware or public domain software on

USDA computers without your supervisor's permission and without scanning
it for viruses. Comply with local office policy on the use of antiviral

Software.

17\. **OBSERVE ALL SOFTWARE LICENSE AGREEMENTS.** Do not violate Federal
copyright laws.

18\. **DO NOT MOVE EQUIPMENT** or exchange system components without
authorization by the appropriate functions and manager's approval.

19\. **PROTECT USDA COMPUTER EQUIPMENT** from hazards such as liquids,
food, smoke, staples, paper clips, etc.

20\. **PROTECT MAGNETIC MEDIA** from exposure to electrical currents,
extreme temperatures, bending, fluids, smoke, etc. Ensure the magnetic

media is secured based on the sensitivity of the information contained,
and practice proper labeling procedures. **BACK UP** critical programs
and data, and store in a safe place. Back ups should be performed as
often as program and data sensitivity require. Erase sensitive data on
storage media before reusing or disposing of the media.

21**. DO NOT DISCLOSE THE TELEPHONE NUMBER(S)** or procedure(s) which
permit system access from a remote location.

22\. **DO NOT SEND OR STORE** Government information on a commercial
E-mail site.

23\. **DO NOT USE** sensitive information for equipment or program test
purposes. Vendors should be escorted and monitored while performing

maintenance duties.

24\. **DO NOT DISCLOSE** or discuss any USDA personnel or vendor related
information with unauthorized individuals. The Privacy Act of 1974, 5
USC 552a, prohibits such disclosure. A person making a willful
unauthorized disclosure of information covered by this act may be
charged with a

Misdemeanor and subject to a fine of up to \$5,000.

25\. **PROMPTLY REPORT** all security incidents to your supervisor and
in accordance with you agency policy on reporting incidents. For
example: unauthorized disclosure of information, computer viruses, theft
of equipment, software or information, and deliberate alteration or
destruction of data or equipment. NEVER assume that someone else has
already reported an incident. The risk of an incident going unreported
far outweighs the possibility that an incident is reported more than
once.

26\. **SEEK** assistance and challenge unescorted strangers in areas
where the system is being used.

27\. **Complete this form when Duties Change, when a separation from the
agency occurs, and to report name changes or request profile changes.**

**AD-1143 FORM INSTRUCTIONS**

**[BLOCK NO.]{.underline}**

1 Check one or more systems. Fill in information for access in Special
Instructions for FedTraveler.com

2 Enter the agency FFIS application number, i.e., FF34 for APHIS, or
FF11 for Forest Service.

**USER INFORMATION**

3 Enter social security number. **The Social Security Number is only
required for adding a user to a FFIS application for the first time.**

4 Enter name.

5 Enter job title or Contractor, if not a USDA employee.

6 Enter address where the user can be contacted by mail.

7 Enter agency name and agency code/number.

8 Enter office, i.e., Financial Management, Procurement Operations.

9 Enter e-mail address.

10 Enter telephone number.

11 Enter manager's telephone number.

**ACTION REQUESTED**

12 Enter "old" name, when requesting a name change.

13 Enter "new" name, when requesting a name change.

14 Check the appropriate action to be taken. If requesting a
modification to your profile, specify in Block 29 the previous profile
or job assignment and the new profile or job assignment. If the user
performs services for additional USDA agencies, e.g., "cross-servicing,
specify the additional agencies(s) and required roles.

15 Enter NFC, FFIS, E-Auth, userid AND if Block 14 is "delete user" or
"modify user", include existing userid. If action requested in Block 14
is "add user", the Agency Security Administrator will assign the userid.

**AUTOMATED CASH RECONCILIATION WORKSHEET SYSTEM ACCESS**

16 Check appropriate Role(s)/Access for ACRWS52.

17 Check appropriate Role(s)/Access for ACRWS53.

18 Reserved.

**CORPORATE PROPERTY AUTOMATED INFORMATION SYSTEM ACCESS**

19 Check UMA Manager. Only to establish Agency designated UMA Managers.

Normal User Access is established via the UMA module within CPAIS.

20 Has user completed CPAIS training? Check Y or N. If Y, enter date
completed.

21 Signature of Authorized Approver and date approved.

**FINANCIAL DATA WAREHOUSE SYSTEM ACCESS**

25 Check either Payroll or Non-Payroll Security Group. Only check one.
The Security Group is available for Security Administrators and

Only the individuals who need to have the access per job duties.

26 Check either Basic User for Canned Reports or Power User for Ad Hoc
Queries. Only check one.

27 Reserved

**INTEGRATED ACQUISITION SYSTEM ACCESS**

28 Check all appropriate roles.

29 Enter requisition approval amount, if user is a Funds Approver.

30 Enter warrant amount, if user is a Contracting Officer. Verify the
amount to be entered here with your supervisor if you are warranted

for a higher amount than your supervisor has authorized you for.

31 Does this user purchase for other agencies? If yes, enter the
agencies here, e.g., Rural Development, Food and Nutrition Service.

**MANAGEMENT INITIATIVES TRACKING SYSTEM ACCESS**

3 Not required.

15 Enter eAuthorization User ID.

32 Check required role.

> See USDA Corporate Website or the MITS Security Features User's Guide
> for definitions of each role. Only one role per MITS module should be
> entered on an individual AD-1143; complete separate AD-1143 documents
> for each additional role.

For PMA: Enter appropriate initiative(s).

HC -- Human Capital CS -- Competitive Sourcing

RP -- Real Property CP -- Credit Programs

FM -- Financial Management eGov -- Egovernement

FBCI -- Faith Based R&D -- Research and Development

IPIA -- Improper Payments BPI -- Budget and Performance Integration

Enter appropriate agency(s).

For PART: Enter appropriate program(s) or "ALL", default is "ALL".

Enter appropriate agency(s).

Enter mission area(s) (required for mission area coordinators only).

Enter PART program(s) -- optional (enter if user should have edit access
for limited PARTs)

For BUDGET: Enter appropriate agency(s).

For AUDIT TRACKING: Enter appropriate agency(s).

Enter mission area(s) (required for mission area coordinators only).

Executive Officer and OIG Auditors role -- Available to OCFO employees
and OIG auditors only.

Audit Follow-up Coordinator role -- Available to OCFO employees only.

##### GOVTRIP.COM

33 Please check the role the user will be in GovTrip.

**Traveler** -- Only view their travel data and submit their own voucher
for approval.

> **Travel Arranger** -- Able to prepare travel plans for designated
> personnel in their agency's organization and able to see the
> information of others.

**Approver**---Able to approve travel vouchers for designated personnel
in their agency's organization.

Agency FATA -- Able to set up configuration for their designated agency.
This should be only a few personnel.

34 Indicate if training has been received.

35 Signature of the requester's supervisor or designated travel manager
in the agency.

**SPECIAL INSTRUCTIONS**

36 Include any additional information needed to complete access. Specify
the security profile or job assignment, or any comments or

special instructions.

> For CPAIS: Provide organization number(s) for which access is being
> requested. If access is needed for all organizations within an agency,
> list agency name and "ALL".
>
> For FFIS: 1) Provide previous profile or job assignment and the new
> profile or job assignment, if modification to existing model; and
>
> 2\) Provide the names of the additional agencies(s) and required
> roles, if the user performs services for additional USDA

agencies, e.g., "cross-servicing.

**USER ACKNOWLEDGEMENT**

**A USER SIGNATURE IS REQUIRED IN THE USER ACKNOWLEDGMENT BLOCK WHEN
THEY ARE ADDED TO A SYSTEM**.

37 User's signature.

38 Date user signed form.

**BACKGROUND INVESTIGATION**

**THIS FIELD MUST BE FILLED OUT. SECURITY ADMINISTRATORS WILL NOT
COMPLETE THE REQUEST UNLESS THIS BOX IS FILLED OUT**

**ACCORDING TO THE INSTRUCTIONS BELOW**

39 Check whether background investigation has been initiated or
completed. This applies to both USDA employees and contractors.

40 Date background investigation was initiated or completed.

41 Name of user's immediate manager

**AUTHORIZATION**

42 Manager's signature.

43 Date manager approved the requested action.

**ACTION TAKEN**

44 Security Administrator's signature.

45 Date Security Administrator completed user's request.

46 Security Administrator can use this space to include any notes
related to the completion of the request. The agency's Security
Administrator will retain each completed form for audit purposes.