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Appendix D - Framework Waiver Request Form

No: 43028139 Date(g): 4/11/2021 | Date(h): 29/3/1443 Status: In-Force

Request for Waiver from the SAMA IT Governance Framework

A submission to the manager of 'General Department of Cyber Risk Control'

The Saudi Arabia Monetary Authority (SAMA) 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 SAMA 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. SAMA DECISION
 		SAMA 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.