FSIS 1360-6 (09/25/2023)a Page 1 of 3

ENTERPRISE 

REQUEST FOR CHANGE (RFC)

U.S. DEPARTMENT OF AGRICULTURE 

FOOD SAFETY AND INSPECTION SERVICE

Title: Implementation Date: (mm/dd/yyyy)

Requesting Office:

Telephone Number: (1234567890)

Government Employee Name:

Government Employee E-mail Address: (firstname.last@usda.gov)

Request Type: (Select one) New Software Release Version

 Software Purchase

 Existing Software Maintenance/Enhancement

 New Application

 Hardware Upgrade/License

 Hardware/Software Support Services

 Firewall

 Documentation

 Hardware Purchase

 Other (Specify below)

Category: (Select box that applies to the type or request) 

 Hardware Documentation

 Software Telecommunications Facilities

 Server Maintenance

Description of Request: (Provide a brief description of your proposed change. Attach additional sheets if necessary.)

Rationale for Change: (Please describe the reasons that necessitate this change. Attach additional sheets if necessary.)

System Owner/Manager Signature:

(Digitally sign document)

Date: (mm/dd/yyyy)
FSIS 1360-6 (09/25/2023)a Page 2 of 3

ADDITIONAL COMMENTS

Request Type: (Specify Other)

Description of Request: (Additional Space. Provide a brief description of your proposed change.)

Rationale for Change: (Additional Space. Please describe the reasons that necessitate this change.)
FSIS 1360-6 (09/25/2023)a Page 3 of 3

INSTRUCTIONS FOR COMPLETING FSIS 1360-6

Page 1 

• Title - Name of Project, Application/Database, Equipment/Service, etc. (indicate the change or nature 

of request) 

• Implementation Date - Proposed date the work will be performed or needs to be performed. This 

date is subject to change by the TCCB pending review of OCIO resources. 

• Requesting Office - Primary Office/Program initiating Request for Change. 

• Government Employee Name - Contact Person. 

• Telephone Number - Telephone number contact person can be reached. 

• Government Employee E-Mail Address - E-Mail address of the contact person. 

• Request Type - Select one box. (Note: If the box labeled 'Other' has been selected, provide the 

request type in the Request Type (Specify Other) section on page 2. 

• Category - Select box that applies to the type or request. 

• Rationale for Change - Provide an explanation for above request. 

• System Owner/Manager Signature - Digitally sign document. If RFC is sent electronically, 

supervisor must be cc'd in original email before it can be accepted by CM Team. 

Page 2 

Additional Comments - Use these sections if additional space is needed to provide a clear explanation of 

the request. Also ensure that server name and other applications affected are listed if applicable. 

INSTRUCTIONS TO SUBMIT FSIS 1360-6

Once the form is completely filled out, save and attach your request to the Service Desk ticket you create in 

Footprints. 

Systems that have Adobe Reader 7.0 or higher are able to use the below advanced features: 

· To save, use the "Save As" function. 

· To add an attachment click the “paper clip emblem” located on the left of the document, select the 

“add” icon on the attachment menu bar, navigate to your document and select the attachment. 

Click open.