Appendix D - Framework Waiver Request Form
| No: 43028139 | Date(g): 4/11/2021 | Date(h): 29/3/1443 |
Effective from 2021-11-04 - Nov 03 2021
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Request for Waiver from the Saudi Central Bank IT Governance Framework
A submission to the manager of 'General Department of Cyber Risk Control'
The Saudi Central Bank (Saudi Central Bank) will consider requests for waiver from a member organization (MO) from its IT Governance Framework based on the information submitted using the form below. A separate form must be completed for each requested waiver. Please note that all required fields must be properly filled in before Saudi Central Bank will begin the review process.
Requestor Information
| REQUESTOR'S SIGNATURE* x | REQUESTOR'S POSITION* | DATE* |
| REQUESTOR'S NAME* | MEMBER ORGANIZATION OF REQUESTOR* | |
| FRAMEWORK CONTROL*: |
| DETAILED DESCRIPTION OF WHY CONTROL CANNOT BE IMPLEMENTED*: |
| DETAILED DESCRIPTION OF AVAILABLE OR SUGGESTED COMPENSATING CONTROLS*: |
Approvals
| 1 .MO's CIO APPROVAL* | DATE* | |
| 2. MO'S IT STEERING COMMITTEE APPROVAL* | APPROVER'S POSITION* | DATE* |
| 3. Saudi Central Bank DECISION | Saudi Central Bank APPROVAL | DATE |
* Denotes required fields
**The validity of this waiver is one year. It is the Member Organizations responsibility to ensure renewal of this waiver.