P R O G R A M C H A N G E / R E Q U E S T F O R M Number: PS ___________

Requested By:	Procedure:
Approved By:	Date:

Does this request have the potential to impact financial information? Yes No

If yes, this PRF must be circulated by the Requestor and reviewed by each of the process owners listed below before submission to the IT Development Team. Process owners must sign in the space provided to denote their approval of the request.

Accounting	Sales/Marketing Support

Tax	Collections/Legal

App Processing/Credit

Detailed Description of Change or New Request (Attach Additional Pages If Necessary)

Completion Control (IT Development Team)

Modules/Procedures:
Comments:

Assignment and Acceptance (IT Development Team)

Assigned/Completed By:	Date:
User Tested By:	Date:
Moved To Production (Executed) By:	Date:
Final Acceptance/Signoff:	Date:

Program Change/Request Form

Bruce Parks

2006-07-24

MicroFinancial, Inc.