Change Proposal Template

A Change Proposal is used by the project team and client organization

to initiate enhancements and modifications to system requirements,
design specifications, and software that are part of an existing
Configuration Management baseline. Directions for completing this
form appear following Page 2 of the form.
Page 1

CHANGE PROPOSAL (CP)

ORIGINATOR NAME & PHONE #:

DATE: ____/____/____

CP IDENTIFICATION #:_____________

FUNCTIONAL AREA(S):

CLASS 1
CLASS 2
(Requires Approval)

DOCUMENTATION[ ]
SOFTWARE

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CONFIGURATION ITEM(S)
AFFECTED:

DESCRIPTION OF CHANGE:

DATE REVIEWED:____/____/____

IN OPERATIONAL BASELINE:
[ ] YES [ ] NO
EFFECT ON CONFIGURATION ITEM SPECIFICATIONS:

Page 2

CHANGE PROPOSAL (CP)

RECOMMENDATION:

SIGNATURE:

CLASS 2 [ ] APPROVE
[ ] APPROVE WITH MODIFICATION (EXPLANATION BELOW)
[ ] DISAPPROVE (EXPLANATION BELOW)
[ ] FURTHER ANALYSIS REQUIRED (EXPLANATION BELOW)

DATE:____/____/____

EXPLANATION:

DATE ASSIGNED TO IMPLEMENT CHANGE:____/____/____

DATE VERIFICATION OF CHANGES

COMPLETED ____/____/____
SIGNATURE:

REVIEW OF MODIFIED DOCUMENTATION/SOFTWARE:

[ ] APPROVE
[ ] DISAPPROVE (EXPLANATION BELOW)

SIGNATURE:
DATE: ____/____/____

EXPLANATION:

DATE IMPLEMENTED: ____/____/____

RELEASE NOTICE:

SIGNATURE:

INSTRUCTIONS FOR COMPLETING CHANGE PROPOSAL (CP)

Originator Name &
Phone Number

Completed by Originator. Name and telephone number of person submitting

request.

Date

Completed by Originator. Date Change Proposal was submitted to

Configuration Management.

CP Identification #

Completed by Configuration Management. Unique identification number

assigned from Change Proposal Log.

Functional
Area(s)

Completed by Originator. Indicate functional area(s) (for example,

component, subsystem) of product affected by the change.

Class 1/Class 2

Completed by Configuration Management. Check appropriate box to indicate

Class 1 or Class 2 change request. Class 1 changes are enhancement,
modifications, or defect corrections that are considered minor in scope and do
not require Process Management approval. Class 2 changes require Process
Management approval.

Documentation/
Software

Completed by Originator. Check appropriate box(es) to indicate if change

request is for documentation, software, or both.

Configuration Item(s)
Affected

Completed by Originator. List all configuration items that are impacted by

the change (documentation and software).

Description of
Change

Completed by Originator. Provide a detailed description of the requested

enhancements or modifications.

In Operational
Baseline

Completed by Originator. Check appropriate box to indicate if change

request is for documentation or software that is currently in production.

ANALYSIS

Completed by Person Performing Analysis

Date Reviewed

Indicate date the Change Proposal analysis was completed.

Effect on Configuration Item

Specifications

Identify, by configuration item, all changes that must be made to

accommodate the request.
(continued on next page)

INSTRUCTIONS FOR COMPLETING CHANGE PROPOSAL (cont.)

Impact on Other Items

Identify, by configuration item, all changes that must be made to

accommodate the request.

Alternative Solution(s)

Indicate any options or alternative means by which the change request can be
implemented.

Development Requirements

Provide a detailed description of development requirements (e.g., people,

time, resources) required to implement the changes.

PROCESS MANAGEMENT

Completed by Process Management Chairman

Recommendation

Check the appropriate box to indicate the Process Management decision to

indicate approval, approval with modification, disapproval of the request, or
if further analysis is required. Provide an explanation for modification and
disapprovals. Process Management chairman or designate signs and dates
the form.

Date Assigned to Implement

Change

Date that the Change Proposal was submitted to the organization responsible
for implementing the change(s)
Completed by Verification Organization. Date that the modified software was
tested and verified as meeting all functional specifications and/or
documentation was reviewed for accuracy and completeness.

Date Verification of Changes

Completed
FINAL APPROVAL

Completed by Process Management Chairman

Review of Modified
Documentation/Software

Check the appropriate box to indicate the Process Management decision

either to approve or disapprove the modifications. Provide an explanation for
disapprovals. Process Management Chairman or designate signs and dates
the form.

IMPLEMENTATION

Completed by Configuration Management

Date Implemented

Date modifications implemented (new baseline established) and Change

Proposal closed

Release Notice

If Change Proposal affects operational baseline, the number of the Release

Notice that transmits change(s) to affected parties

Signature

Signature of Configuration Management Chairman