Service Entry Permit

Third-Party Asset Access & Toolset Verification

Doc ID: TAG-OT-SEP-02
Compliance: IACS UR E27 §4.5
Rev: 1.0

1. SERVICE PARAMETERS

Technician:	________________	Date:	________________
Company:	________________	System:	[ ] AMS [ ] NAV [ ] OTHER

2. TOOLSET & MEDIA VERIFICATION

Verify all external engineering tools before connection to any OT network.

Description (Laptop/USB/Tool)	Serial / Asset No.	AV Scanned?	Action
________________	________________	[ ] Yes [ ] N/A	[ ] Allow [ ] Deny
________________	________________	[ ] Yes [ ] N/A	[ ] Allow [ ] Deny

3. ACCESS AUTHORIZATION

Network Access: [ ] Denied [ ] Service VLAN

Wireless Access: [ ] Not Allowed [ ] Temporary

Remote Access: [ ] Jump Server [ ] Direct (Auth Required)

USB Use: [ ] Scanned Only [ ] Denied

Technician Declaration: I confirm that the engineering tools brought onboard have been scanned for malware within the last 24 hours. I will not install unauthorized software or hardware and will notify the ETO of any system configuration changes.

Technician Signature:

Full Name & Date

Authorizing Officer (ETO):

Rank, Signature & Date

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