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IDIS Online Access Request U.S. Department of Housing and Urban Development Office of Community Planning and Development OMBAppree d No. 2506-0171cup 04/30/2020 Privacy Act Statement: Public Lew 97.255, Flnancial Integrity Act, 31 U.S.C. 3512, authcHEee the Department of Housing and Urban Development (HUD) to collect all the Information whlch WII be used by HUD m Protect disbunennI data from fraudulent arH ,B The purpose of the data Is to safeguard the Integrated Disbursement and Information System iID151 from una uthorlaed access. The data are used to ensure that individuals who no longer require access to IDIS have their accese capability Prempap deleted. This Inferm rile, will not be otherwise duel osed or released outside of HUD, axceptas permitted or required by law. Failure to provide the Information requested on the form may delay the p Dessmar, of yourapproval for access to IDIS, Public Reporting burden for this Information EDlleRlon Is estimated to avenge 30 minutes Including time for collecting, reviewing, and "porting data, HUD may not collect thls Information, and respondents are not required to mmpletb this form, unless It displays a cunantly valid OMB central Number. GRANTEE & REQUE$TOR INFORMATION REQUEST TYPE ■IIIR7l�I11�wwa�r�l��.�� New Request ❑ ❑ Drop from IDIS Renew Lapsed ID ❑ Change Function or Program Area ❑ Change Name ❑ Add Access for Another Grantee t .. Please create a flue digit pin that will be used for password resets. [ 9] [ 11 (3 ] [ 7 ] (l j Requestor's Name (Last, First, MI): Office E-mail Address: Luis, Esther eluis@mdg-Idm.com Office Address: Office Phone: ext.: 10722 Arrow Route, Suite 822., Rancho Cucamonga, CA 91730 (909) 476-9696 107 Grantee Name in IDIS: .. ,, ......... ............. ._...._.. ......._ .. _.._ GR/dN'PBBTYPE... City of Santa Ana City ® County ❑ State Non Profit ❑Sub Grantee* ❑ Please Mark All tJecessary Functions & Programs - Set Up Activity ® Request Drawdown us g ApproveDrawdown❑ Local IDIS Administratorn ' CDBG ® HOME ® ESG ❑ HOPWA ❑ HESG ® HOPWA-C ❑ HTF ❑ Other; If other, please specify name of program *Approval of Sta#e Sub Grantee Request — CPD State Coordinator or State Official name, signature and date: Name: Signature: Date: Can Plan.'. Create/Edit/Submit ® Edit ® View Caper: Create/Edit/Submit Edit ® View IDIS Online Rules of Behavior September IA, 201E Introduction This Rules of Behavior (ROB) procedure was developed as a guide to ensure that all users of IDIS Online are made aware of their security responsibilities before accessing IDIS Online. The ROB defines responsibilities and procedures for secure use of IDIS Online. By reading and acknowledging these rules, users accept the responsibility to protect IDIS Online and data. Users are accountable for their actions and the requirements to protect IDIS Online data and equipment from both malicious and accidental loss and damage. These rules clearly delineate the responsibilities of and expectations for all individuals with access to IDIS Online. Non-compliance with these rules will be enforced through sanctions commensurate with the level of infraction. Responsibilities All authorized users who have access to IDIS Online are required to read, acknowledge understanding, and sign the ROB before accessing IDIS Online and associated data. This acknowledgement must be completed annually thereafter. By agreeing to and signing these rules, the user signifies: 1. Understanding that access is given only to IDIS Online to which the user requires access in the performance of their official duties and the user will not attempt to access systems they are not authorized to access. ALL PREVIOUS Val Some OFTHIS FORM WILL NOT BE ACCEPTED OR PROCESSED. BUD FORM 27055105-15-20171 Page l F?I