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INSTRUCTIONS

This document is divided into several sections, each containing three types of questions. There are questions requiring a specific response, which have a space for the data. Other questions require a response of “Yes,” “No,” or “NA,” and have a response block and space for your comments, explanations, or questions. There are also tables that should be self-explanatory. This document is set up in table format. All responses can be included in the document itself (with the exception of requested attachments).

GENERAL INFORMATION ITEMS

Please attach documents covering the following topics and check the items that are attached.

__________ Computer and peripheral hardware listing

__________ Purchased and written software listing

__________ Organization chart and position descriptions

__________ Data center and department floor plan

__________ Network diagram

TABLE OF CONTENTS

GENERAL CONTROL TOPICS SECTION
Administration A
Physical security B
Logical security C
Change management D
Backup, recovery, and contingency planning E
Operations F

A. INFORMATION SYSTEMS ADMINISTRATION

Organization

1. Personnel Number (If Part Time)
Hours/Week
a. Managers
b. Technical Support Programmers
c. Systems Analysts
d. Analyst/Programmers
e. Programmers
f. Computer Operators
g. Other

Annual Budget or Estimated/Actual Expenditures

2. Hardware (CPU, printers, etc.) Budget or Actual
Dollars
a. Lease/Rental Expense
b. Maintenance Fee/Charges
c. Depreciation
d. Other
3. Software (packages, support programs)
a. License, Rent, Maintenance Fees
b. Amortization of Purchased Package
c. Other
4. Personnel (hourly/salary wages)
5. Supplies (paper, ribbons, etc.)
6. Total Budget or Approximate Expense for Information Systems Department

Computer Hardware

7. Item Quantity Model Size
a. Processors
b. Disk Units
c. Tape Units
d. Printers
e. Other
8. Item Install Date Acquisition
a. Processors Buy or Lease
b. Disk Units Buy or Lease
c. Tape Units Buy or Lease
d. Printers Buy or Lease
e. Other Buy or Lease

Computer Software

9. System Support Software Purchase
Price
Vendor
Maintenance
Cost/Year
a. Operating System(s)
b. Telecommunications Access System
c. Database System(s)
d. Decision Support System(s)
e. Office System(s)
f. System Development Aid(s)
g. System Security Software
h. Utilities
i. Other

Application Software

10. Application Purchase
Price
Vendor
Maintenance
Cost/Year
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
11. Planned Use of Staff Staff Days
a. New Systems Development and Training
b. Maintain/Support Existing Systems
12. Computer Operations Schedule Days/Week Hours/Day
a. Computer is operational
b. Computer support is staffed
13. IT Planning
Y/N a. Do you have a written short- or long-range plan for information technology activities?
Y/N b. Is there a management steering committee that oversees information technology projects and priorities? If so, how often does the committee meet?
Y/N c. Is there an annual plan for scheduled application projects? Please attach a copy.

COMMENTS

Y/N 14. Is departmental charge-back (or other allocation of information technology costs) used? What is the basis for the charges?
Y/N Is there a separate calculation for production usage versus development charges?


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