Email Delegation Request Form   

 
Email delegation requests MUST be approved by the Information Security Officer (ISO) for the agency who owns the account to be delegated.  

When this form is submitted, it will be sent to the email address you provided for the Approving ISO to review.  After the ISO reviews this form, the EITS Helpdesk will process this request accordingly.
   

Information of Employee Needing Access

First Name:      
Last Name:      
E-Mail Address:      

Information of Delegated User

First Name:      
Last Name:      
E-Mail Address:      
Budget Code:      

Information of Requester

 

First Name:      
Last Name:      
E-Mail Address:      

The below information must be filled out.
When you click on the submit button, it will send an email to your agency’s ISO for approval.
The ISO must then forward this email to EITSHelp@admin.nv.gov with their approval.

 

Information of Approving ISO 
First Name:      
Last Name:      
E-Mail Address:      
             Is this a removal of a delegation?     
     Add Send on Behalf of or Send As rights     
                               


Special Instructions
          
   

  
 
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