Request For Flat File Access ASR Information: I affirm the data I am requesting will be used in accordance with the aggreement specified by the steward(s) and I have read and understand University policies AD-20, "Data Security and Privacy" and AD-23 "Use of Computerized Institutional Data". Your UserID@HOST: (i.e. abc1@psu.edu) Admin Area: Phone: Purpose of Request: (Specify why access is needed) Scope of Data: (Specify population, data values or selection criteria) File Identification: (List the specific file name. One file per request) Individual Info: (Enter name and userid of individuals to access the file) * You will receive a copy of the submitted form via email.

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