OFFICE USE ONLY: Date Completed: SE Signature: Customer Add/Delete User Request Form (This is for RoseASP authorization to add/delete the Active Directory acct – for application acct modification, either customer or consultant will execute that change) 1. Check One: Add or Delete user: Add Delete* 2. Customer/Company Name: ______________________________________ 3. New/Existing User First and Last Name: ____________________________ 4. For New User – Email Address:____________________________________ 5. Existing user account that this new account should be copied for identical permissions, etc. (if applicable) _____________________________________________________________ 6. Required Date of activation / deletion: _____________________________ 7. MR Security Role (circle one): Administrator, Generator, Designer or Viewer 8. I hereby authorize the creation of the above requested account/user within my Dynamics ERP system as well as the monthly associated fees: Check One: Dynamics Concurrent/Named User (requires additional Dynamics License)** Web Client Only, No Windows Desktop Dynamics Light User – GP/NAV Only (read access) Citrix Desktop (No ERP or MS Office, MR Included) Additional Windows/Web login only 9. Print Authorized Requestor Name: ________________________________ Signature:____________________________ Date: _________________ *For immediate removal of a terminated employee please call 858 794-9403 (all deletes will be done within 24 hours or the next business day for weekend requests) **Full User licenses provide users full read and full write capabilities to all of the licensed solution functionality through any and all modes of access, including the Windows Client, the Web Client, or, in the case of Microsoft Dynamics NAV 2015, the Microsoft SharePoint Client or any other mode of access going through the API (including Web Services). Full User licenses are for users requiring unlimited read and write access to the complete solution functionality. Limited User licenses provide users full read, but limited write, capabilities to all of the licensed solution functionality through any and all modes of access including the Windows Client. The Limited User license is designed to give customers a lowercost alternative for extending ERP Dynamics ERP Add Delete User Form Confidential Page 1 11/11/2023