SERVICE NO: QP06-12 SERVICE NO: QP06-12 REQUEST FORM VERSION: V2.5 Managed Security Service EFFECTIVE DATE: 1 JANUARY 2016 -Change Request PAGE :1 OF 2

## Managed Security Service – Change Request Form (to be completed by customer)

Explanation Notes:
• sections must be completed and an authorizing Signature included on the SR Cover • sections must be completed and an authorizing Signature included on the SR Cover Application Form. 1-Net cannot process your Change Request without an authorising signature. In accordance with 1-Net’s compliance with Security Industry Best Practice and the IDA’s • (Infocomm Development Authority) IT Security Guidelines, change requests made through phone calls, emails, verbal requests and requests not submitted on the official Change Request Form and then sent to the 1-Net will NOT be accepted and processed. This is to ensure that 1-Net only processes legitimate Change CSC Requests from authorised customer delegates. Change Request Forms are available from your 1-Net Account Manager, 1-Net CSC and from the www.1-net.com.sg site. NB: A Change Request Fee is applicable to each separate Change Request Form submitted (excluding Free Monthly Change Request)
Service Subscribed:
Current MSS Service Type: Basic Premier Dedicated Remote
Change Details: (to attach additional information if necessary)
Validity of Firewall Rules: Permanent Temporary : __ __ (Note: For Temporary rule, please specify the Expiry Month and Year) Source Destination Protocol (TCP / UDP) & Service Port No. (TCP / Action Comment UDP) & Service Port No. Remarks Source: Source of packet (e.g. Internet, Internal, 203.117.111.6 or symbolic name which will equate to IP) Destination: Where the packet is going (e.g. Internet, Internal, 203.117.111.6 or symbolic name which will equate to IP) If Firewall Rule requested is for a subnet, provide the appropriate subnet mask (/16, /23, /24, etc.) Service: Protocol and Port number (e.g. TCP/80, UDP, HTTPS (SSL), SMTP (mail), Telnet, FTP) for software Action: What to do with a packet (e.g. Accept, Reject or Drop) Comment: Description to clarify the requirements of this rule
Validity of Firewall Rules: Permanent Temporary : __ __ (Note: For Temporary rule, please specify the Expiry Month and Year) Source Destination Protocol (TCP / UDP) & Service Port No. (TCP / Action Comment UDP) & Service Port No. Remarks Source: Source of packet (e.g. Internet, Internal, 203.117.111.6 or symbolic name which will equate to IP) Destination: Where the packet is going (e.g. Internet, Internal, 203.117.111.6 or symbolic name which will equate to IP) If Firewall Rule requested is for a subnet, provide the appropriate subnet mask (/16, /23, /24, etc.) Service: Protocol and Port number (e.g. TCP/80, UDP, HTTPS (SSL), SMTP (mail), Telnet, FTP) for software Action: What to do with a packet (e.g. Accept, Reject or Drop) Comment: Description to clarify the requirements of this rule Comment Destination Action Source	Validity of Firewall Rules: Permanent Temporary : __ __ (Note: For Temporary rule, please specify the Expiry Month and Year) Source Destination Protocol (TCP / UDP) & Service Port No. (TCP / Action Comment UDP) & Service Port No. Remarks Source: Source of packet (e.g. Internet, Internal, 203.117.111.6 or symbolic name which will equate to IP) Destination: Where the packet is going (e.g. Internet, Internal, 203.117.111.6 or symbolic name which will equate to IP) If Firewall Rule requested is for a subnet, provide the appropriate subnet mask (/16, /23, /24, etc.) Service: Protocol and Port number (e.g. TCP/80, UDP, HTTPS (SSL), SMTP (mail), Telnet, FTP) for software Action: What to do with a packet (e.g. Accept, Reject or Drop) Comment: Description to clarify the requirements of this rule Comment Destination	Protocol (TCP / UDP) & Service Port No.	Validity of Firewall Rules: Permanent Temporary : __ __ (Note: For Temporary rule, please specify the Expiry Month and Year) Source Destination Protocol (TCP / UDP) & Service Port No. (TCP / Action Comment UDP) & Service Port No. Remarks Source: Source of packet (e.g. Internet, Internal, 203.117.111.6 or symbolic name which will equate to IP) Destination: Where the packet is going (e.g. Internet, Internal, 203.117.111.6 or symbolic name which will equate to IP) If Firewall Rule requested is for a subnet, provide the appropriate subnet mask (/16, /23, /24, etc.) Service: Protocol and Port number (e.g. TCP/80, UDP, HTTPS (SSL), SMTP (mail), Telnet, FTP) for software Action: What to do with a packet (e.g. Accept, Reject or Drop) Comment: Description to clarify the requirements of this rule Comment Destination Action	Validity of Firewall Rules: Permanent Temporary : __ __ (Note: For Temporary rule, please specify the Expiry Month and Year) Source Destination Protocol (TCP / UDP) & Service Port No. (TCP / Action Comment UDP) & Service Port No. Remarks Source: Source of packet (e.g. Internet, Internal, 203.117.111.6 or symbolic name which will equate to IP) Destination: Where the packet is going (e.g. Internet, Internal, 203.117.111.6 or symbolic name which will equate to IP) If Firewall Rule requested is for a subnet, provide the appropriate subnet mask (/16, /23, /24, etc.) Service: Protocol and Port number (e.g. TCP/80, UDP, HTTPS (SSL), SMTP (mail), Telnet, FTP) for software Action: What to do with a packet (e.g. Accept, Reject or Drop) Comment: Description to clarify the requirements of this rule Comment

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