Technology Service Request

TSR #{ticketNumber23}
Submission Date/Time

YearMonthDay
Date
Hour Minutes
Technology Service Request
If this is a mission critical system outage, please contact the stand-by technician at 240.777.2233 and select Option 1.
NAME*

First NameLast Name
FDID*
STATION/WORKSITE*
Please select the station/worksite experiencing the problem if different from your normal station/worksite. If teleworking, please select your assigned worksite.
SHIFT*
Station/Worksite Contacts
EMAIL ADDRESS*
example@example.com
PHONE NUMBER*
Format: (000) 000-0000.
NATURE OF PROBLEM OR INQUIRY (CATEGORY)*
TechTip: https://mcfrsit.com/wordpress/choosing-the-right-tsr-category/
Category Notification Recipients
Category Contact Language
If you have any questions or concerns about your ticket, I advise you to contact the assigned technician, but you may reach out to me:
Category Signature
Jeff Feiertag
FRS Technology Section
jeff.feiertag@montgomerycountymd.gov
301.814.1953
With the exception of computer login exemption requests, IT Exemptions can only be requested by Section Chiefs and Division Chiefs. If you have a need and are not eligible to make the request please reach out to your Chain of Command.
This type of request requires you to fill out another form for it to be processed and approved. You'll be able to provide the exact details of your request in that second form, so please just give us a short description below so we can be sure it's routed properly. Within the next two business days, you will receive an email containing the link to the second form that needs to be completed.
MESSAGING*
By using and receiving information from this system, you consent to the following conditions (all boxes must be checked to continue):*

At any time the Montgomery County Government may remove any user or contact in this system for cause.The information communicated within this program is private, for the official use only of public safety and other authorized personnel, and is intended for use solely by the individual that the account has been granted, established, and authorized for.Distribution, publication, or any other use not explicitly authorized in writing is strictly prohibited.All information is considered confidential and owned wholly by Montgomery County Government.
CONFIRM EMAIL ADDRESS*
example@example.com
PHONE NUMBER*
Format: (000) 000-0000.
DEPARTMENT*
SPECIFY OTHER JURISDICTION
SUPERVISOR (LT OR HIGHER)*

First NameLast Name
SUPERVISOR'S TITLE/RANK*
SUPERVISOR'S EMAIL*
example@example.com
SUPERVISOR'S PHONE*
Format: (000) 000-0000.
Is your device already registered with Active911?*

YesNo
DEVICE CODE*
DEVICE TYPE*
DEVICE OS*
Note: We will send you the device code within the TSR closed ticket notification. You will have two weeks to set up and pay for the account thereafter. We reserve the right to delete the device from our system if you have not subscribed by that time.
COMMENTS/REQUEST DETAILS*
DCM#
Please include if your problem/inquiry is for a specific machine
Attachments:

Please add any attachments to your request here. Provide context as to the attachments in the comments/request section of this form.
Cancelof
PRIORITY
OFFICE USE ONLY

TSR #{ticketNumber23}
DISPOSITION
Assigning MANAGER / PERSON
WHO IS ASSIGNING THIS TICKET TO THE TECHNICIAN
Assigned TECHNICIAN
Technician email
Completed Date/Time

MonthDayYear
Date
Hour Minutes
ADMINISTRATOR NOTES
TECHNICIAN NOTES
*CUSTOMER WILL SEE WHAT YOU TYPE HERE*
Additional Recipients of Updates
List email addresses of additional recipients for email updates for this TSR. Email addresses need to be comma separated.
WORK HOURS
Should be Empty: