NEW UPDATE DELETION State of Individual Confidentiality Agreement – - Nevada Executive Budget System (NEBS) for Access to the Governor’s Finance Office Activity Budget Bill Draft Request Module (BDR) SECTION 1 - USER INFORMATION Employee Full Name: Employee ID #: Title: Phone Number & Extension: Fax Number: E-Mail Address: ( ) ( ) Work Address: Department & Agency Name: Agency Number (3-digit): Home Org. (B/A): SECTION 2 AGENCY ACCESS – AGENCY ACCESS AUTHORIZES THE USER TO HAVE ACCESS TO ALL BUDGET ACCOUNTS ASSIGNED TO AN AGENCY – NUMBER Agency the applicable role(s) SECURITY ROLES: Place an “X” in Number (BDR Only) (BDR Only) Agency Name (3-digit) Inquiry Only Data Entry Administrator Director If this is a new request, has the prior incumbent’s access been deleted? SECTION 3 AGREEMENT BETWEEN THE EMPLOYEE AND HIS/HER APPOINTING AUTHORITY – By signing this agreement, the employee agrees to the following: I will keep all information in NEBS confidential. I will not share access with any individuals not authorized by the Governors Finance Office Budget Division. I will direct any questions regarding the use to the authorized representative in the Governors Finance Office. This agreement applies to the person named above only while occupying the position listed above. I agree to preserve the secrecy of my password and the security of NEBS. I will never allow any person to use my sign-on and password to access NEBS. Violations of this agreement will result in the immediate termination of this agreement and may also result in disciplinary action. Employee Signature: Date: Appointing Authority (Print Name): Appointing Authority Signature: Date: Signature: Date: EMAIL THE COMPLETED FORM TO YOUR ASSIGNED BUDGET ANALYST WITH A COPY TO THE BUDGET DIVISION AT Revised 12/18/2015
NEW UPDATE DELETION State of – Individual Confidentiality Agreement for Access to the Governor’s Finance Office - Nevada Executive Budget System (NEBS) Activity Budget Bill Draft Request Module (BDR) SECTION 1 - USER INFORMATION Employee Full Name: Employee ID #: Title: Phone Number & Extension: ( ) Fax Number: ( ) E-Mail Address: Work Address: Department & Agency Name: Agency Number (3-digit): Home Org. (B/A): SECTION 2 – AGENCY ACCESS AGENCY ACCESS – AUTHORIZES THE USER TO HAVE ACCESS TO ALL BUDGET ACCOUNTS ASSIGNED TO AN AGENCY NUMBER Agency Name Agency Number (3-digit) SECURITY ROLES: Place an “X” in the applicable role(s) Inquiry Only Data Entry (BDR Only) Administrator (BDR Only) Director If this is a new request, has the prior incumbent’s access been deleted? SECTION 3 – AGREEMENT BETWEEN THE EMPLOYEE AND HIS/HER APPOINTING AUTHORITY By signing this agreement, the employee agrees to the following: I will keep all information in NEBS confidential. I will not share access with any individuals not authorized by the Governors Finance Office Budget Division. I will direct any questions regarding the use to the authorized representative in the Governors Finance Office. This agreement applies to the person named above only while occupying the position listed above. I agree to preserve the secrecy of my password and the security of NEBS. I will never allow any person to use my sign-on and password to access NEBS. Violations of this agreement will result in the immediate termination of this agreement and may also result in disciplinary action. Employee Signature: Date: Appointing Authority (Print Name): Appointing Authority Signature: Date: Signature: Date: EMAIL THE COMPLETED FORM TO YOUR ASSIGNED BUDGET ANALYST WITH A COPY TO THE BUDGET DIVISION AT Revised 12/18/2015
Activity_Budget_-_BDR_Access_Form.docx