1. Requestor Information
2. Location of Problem
3. Problem Details

• Requestor Information
• Location of Problem
• Problem Details

• Requestor Information
• Location of Problem
• Problem Details

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Requestor Information

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Title

Name

E-Mail

Please fill out this field.

Phone

Ext.

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Location of Problem

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Agency / Company

Please fill out this field.

Address

Please fill out this field.

Building / Floor / Room

City, State Zip

Please fill out this field.

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Problem Details

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Problem Type

Data Circuit Email Hardware - Computer Related Internet Printer / Scanner Software / Application Telephone (non-Wireless) Other

Please select an item in the list.

Circuit ID

What is the circuit ID having the problem?

Can the circuit be interrupted for testing?

Yes

No

N/A

Please include your email address above.

Do you have access to email via webmail

Yes

No

Don't know how

For Office365 users this can be done by visiting https://outlook.office365.com

Please ensure that the information requested below is from the actual hardware with the problem. e.g. if the PC is broke, give us the tag # from the PC not the Monitor.

Type of Hardware

pc, monitor, laptop, etc.

Can you browse to http://www.illinois.gov?

Yes

No

N/A

Can you browse to http://www.google.com?

Yes

No

N/A

What is the address of the site you are having problems with?

e.g. http://www.illinois.gov/pages/default.aspx

What is the Phone Number?

What is telephone number having the problem along with ext number?

What is the model number?

VOIP MAC Address

If the telephone number being reported is a VoIP telephone, than please provide the MAC address located on the bottom of the phone.

Tag # for Hardware

Serial #

Make / Model

Are multiple users affected?

Yes

No

N/A

Enter Site Contact information if different than above.

Site Contact Name

Site Contact Phone

What are the hours of operations?

Time Available

What is the time(s) that the individual will be available for callback?

Re-occurring problem?

Yes

No

N/A

Is the problem being reported a re-occurring problem?

Recent service requests?

Yes

No

N/A

Have there been any recent service requests which may have caused the problem?

What date did the problem occur?

What time did the problem occur?

12:00 AM 12:30 AM 1:00 AM 1:30 AM 2:00 AM 2:30 AM 3:00 AM 3:30 AM 4:00 AM 4:30 AM 5:00 AM 5:30 AM 6:00 AM 6:30 AM 7:00 AM 7:30 AM 8:00 AM 8:30 AM 9:00 AM 9:30 AM 10:00 AM 10:30 AM 11:00 AM 11:30 AM 12:00 PM 12:30 PM 1:00 PM 1:30 PM 2:00 PM 2:30 PM 3:00 PM 3:30 PM 4:00 PM 4:30 PM 5:00 PM 5:30 PM 6:00 PM 6:30 PM 7:00 PM 7:30 PM 8:00 PM 8:30 PM 9:00 PM 9:30 PM 10:00 PM 10:30 PM 11:00 PM 11:30 PM

Specific Application

Central Payroll Citrix (Remote Access) ePass (Electronic Payroll) ERP eTime (Electronic Timekeeping) iLogin Other (Please specify below)

Please select the appropriate application which you are experiencing issues with, if the application is not specified choose other and list the application where allowed.

Application Area

Accounts & Identity Management

Please choose the Specific Area of the ERP Application you are experiencing an issue with.

Application Problem Area

Hidden Application Problem Area Vale

What browser are you using to try to access Citrix?

Chrome Firefox Internet Explorer Edge (Blue E Icon) Edge (Blue/Green Circular Icon)

Please select an item in the list.

Have you cleared your browser cache

Yes

No

If you aren't sure how to do that, see this link https://www.digitaltrends.com/computing/how-to-clear-your-browser-cache/

Have you connected to Citrix before

Yes

No

Have you rebooted your PC

Yes

No

Payroll Agency Name

Please fill out this field.

CPS Agency Number

Please fill out this field.

CPS Pay Code

Please fill out this field.

CPS Schedule

Please fill out this field.

Name of Application

Please specify the name of the application you are experiencing issues with.

Description of Problem

DO NOT include sensitive personal information such as Social Security numbers, driver’s license or state ID numbers, financial account details, or medical information. Please include as much detail as possible about the issue you are experiencing.

Error Messages

Please include error message you are receiving.

Attachments

Choose Files

Multiple files can be uploaded by holding down Shift or Ctrl while selecting.

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