Project Name: Date Prepared: <YYYY-MM-DD> Prepared by: Change Number: Detailed Description of Proposed Change: <Describe the details of the proposed change, including who is proposing the change, what the current state is, etc…> Justification for Proposed Change: <Argue the benefit of the change or the risk that the change mitigates, versus the cost of the change.> Impacts of Change: Increase Decrease Modify Scope <Details about changes to scope, constraints, or requirements> Increase Decrease Modify Cost <Details about cost implications> Increase Decrease Modify Schedule <Details about schedule/time implications> Increase Decrease Modify Risk <Details about the change to risk, corresponding to this change> Increase Decrease Modify Project Documents <Details about changes to other project documents, like the Change Control Plan, HR Plan, etc…> Disposition: Approve Defer Reject Justification of Decision: <Give the reasoning of the Change Control Board about why the change was approved, deferred or rejected> Change Control Board Signatures: Name Signature Name Signature Date:
Project Name: Date Prepared: <YYYY-MM-DD> Prepared by: Change Number: Detailed Description of Proposed Change: <Describe the details of the proposed change, including who is proposing the change, what the current state is, etc…> Justification for Proposed Change: <Argue the benefit of the change or the risk that the change mitigates, versus the cost of the change.> Impacts of Change: Scope Increase Decrease Modify <Details about changes to scope, constraints, or requirements> Cost Increase Decrease Modify <Details about cost implications> Schedule Increase Decrease Modify <Details about schedule/time implications> Risk Increase Decrease Modify <Details about the change to risk, corresponding to this change> Project Documents Increase Decrease Modify <Details about changes to other project documents, like the Change Control Plan, HR Plan, etc…> Disposition: Approve Defer Reject Justification of Decision: <Give the reasoning of the Change Control Board about why the change was approved, deferred or rejected> Change Control Board Signatures: Name Signature Name Signature Date:
change_request.docx