This is a template a company can use to obtain user acceptance during the commission
of a business project. The form first identifies the project name and project title. The
user then must evaluate project deliverables by using specific acceptance criteria. The
form also requires the user to report any outstanding issues and provide a resolution
plan. This template can be used by small businesses or other entities that want to
obtain user acceptance or feedback for project deliverables.
User Acceptance Report
A. General Information
Provide basic information about the project including: Project Title – The proper name used to identify this project; Project Working Title – The working name or
acronym that will be used for the project; Proponent Secretary –The Secretary to whom the proponent agency is assigned or the Secretary that is sponsoring an
enterprise project; Proponent Agency – The agency that will be responsible for the management of the project; Prepared by – The person(s) preparing this document
Date/Control Number – The date the report is finalized and the change or configuration item control number assigned.
Project Title: Project Working Title:
Proponent Secretary: Proponent Agency:
Prepared by: Date/ Control Number:
B. Project Deliverables and Acceptance Criteria Validation
In the first column, list the Project Deliverables specified in the Project Performance Plan. List the user Acceptance Criteria for each Deliverable in the second column.
In the third column, indicate the Results of User Evaluation of the deliverable by indicating with a Yes or No if each part of the acceptance criteria has been meet.
Deliverable Acceptance Criteria Results of User Evaluation
C. Outstanding Issues and Resolution Plan
Provide a description of the Outstanding Issues related to the Deliverable Acceptance Criteria. Describe any plans to resolve standing issues if they exist after Project
D. Acceptance Signatures
The signatures below signify that the deliverables described in the Project Plan and listed in Section above are acceptable to the user in their current configuration. The
undersigned agree to the resolution plans for any outstanding issues as described in Section C above.
Position/Title Signature/Printed Name/Title Date
Proponent Agency Head
Project Sponsor (required)
Project Manager (required)
Business Partner (Contractor)
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