# Formulário para conta de rede

[![image.png](https://base.ifpa.edu.br/uploads/images/gallery/2023-06/scaled-1680-/0c1CI1PIKBzXhA2C-image.png)](https://base.ifpa.edu.br/uploads/images/gallery/2023-06/0c1CI1PIKBzXhA2C-image.png)

[ ](https://base.ifpa.edu.br/uploads/images/gallery/2023-06/0c1CI1PIKBzXhA2C-image.png)[![image.png](https://base.ifpa.edu.br/uploads/images/gallery/2023-06/scaled-1680-/2mcyz13zHaxzr9Ah-image.png)](https://base.ifpa.edu.br/uploads/images/gallery/2023-06/2mcyz13zHaxzr9Ah-image.png)

**<span style="font-family: 'Calibri',sans-serif; mso-fareast-font-family: Calibri;">Serviço Público Federal </span>**

**<span style="font-family: 'Calibri',sans-serif; mso-fareast-font-family: Calibri;">Ministério da Educação </span>**

**<span style="font-family: 'Calibri',sans-serif; mso-fareast-font-family: Calibri;">Secretaria de Educação Profissional e Tecnológica </span>**

**<span style="font-family: 'Calibri',sans-serif; mso-fareast-font-family: Calibri;">Diretoria de Tecnologia da Informação</span>**<span style="font-size: 11.0pt; line-height: 107%; font-family: 'Calibri',sans-serif; mso-fareast-font-family: Calibri;"> </span>

**<span style="color: #333333;">CADASTRAMENTO PARA ACESSO A REDE DE INFORMÁTICA DO IFPA</span><span style="font-size: 9.0pt; mso-bidi-font-size: 11.0pt; line-height: 107%; color: #333333;"> </span>**

<span style="mso-spacerun: yes;"> </span>

**<span style="mso-bidi-font-size: 10.0pt; line-height: 107%;"><span style="mso-list: Ignore;">I.<span style="font: 7.0pt 'Times New Roman';"> </span></span></span>****<u style="text-underline: black;">IDENTIFICACAO DO USUARIO</u><span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; line-height: 107%;"> </span>**

<table border="0" cellpadding="0" cellspacing="0" class="TableGrid align-center" id="bkmrk-nome-completo%3A-%C2%A0-%C2%A0-c" style="width: 530.3pt; border-collapse: collapse; mso-yfti-tbllook: 1184; mso-padding-alt: 2.35pt 5.75pt .4pt 5.4pt;" width="707"><tbody><tr style="mso-yfti-irow: 0; mso-yfti-firstrow: yes; height: 14.75pt;"><td style="width: 111.7pt; border: solid black 1.0pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.75pt;" valign="top" width="149">Nome completo: <span style="mso-spacerun: yes;"> </span>

</td><td style="width: 418.55pt; border: solid black 1.0pt; border-left: none; mso-border-left-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.75pt;" valign="top" width="558"><span style="mso-spacerun: yes;"> </span>

</td></tr><tr style="mso-yfti-irow: 1; height: 14.75pt;"><td style="width: 111.7pt; border: solid black 1.0pt; border-top: none; mso-border-top-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.75pt;" valign="top" width="149">Campus:<span style="mso-spacerun: yes;"> </span>

</td><td style="width: 418.55pt; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; mso-border-top-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.75pt;" valign="top" width="558"><span style="mso-spacerun: yes;"> </span>

</td></tr><tr style="mso-yfti-irow: 2; height: 14.9pt;"><td style="width: 111.7pt; border: solid black 1.0pt; border-top: none; mso-border-top-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.9pt;" valign="top" width="149">Cargo:<span style="mso-spacerun: yes;"> </span>

</td><td style="width: 418.55pt; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; mso-border-top-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.9pt;" valign="top" width="558"><span style="mso-spacerun: yes;"> </span>

</td></tr><tr style="mso-yfti-irow: 3; height: 14.75pt;"><td style="width: 111.7pt; border: solid black 1.0pt; border-top: none; mso-border-top-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.75pt;" valign="top" width="149">Descrição:<span style="mso-spacerun: yes;"> </span>

</td><td style="width: 418.55pt; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; mso-border-top-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.75pt;" valign="top" width="558"><span style="mso-spacerun: yes;"> </span>

</td></tr><tr style="mso-yfti-irow: 4; height: 14.75pt;"><td style="width: 111.7pt; border: solid black 1.0pt; border-top: none; mso-border-top-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.75pt;" valign="top" width="149">SIAPE:<span style="mso-spacerun: yes;"> </span>

</td><td style="width: 418.55pt; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; mso-border-top-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.75pt;" valign="top" width="558"><span style="mso-spacerun: yes;"> </span>

</td></tr><tr style="mso-yfti-irow: 5; height: 14.9pt;"><td style="width: 111.7pt; border: solid black 1.0pt; border-top: none; mso-border-top-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.9pt;" valign="top" width="149">CPF:<span style="mso-spacerun: yes;"> </span>

</td><td style="width: 418.55pt; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; mso-border-top-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.9pt;" valign="top" width="558"><span style="mso-spacerun: yes;"> </span>

</td></tr><tr style="mso-yfti-irow: 6; height: 14.75pt;"><td style="width: 111.7pt; border: solid black 1.0pt; border-top: none; mso-border-top-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.75pt;" valign="top" width="149">Data de nascimento:<span style="mso-spacerun: yes;"> </span>

</td><td style="width: 418.55pt; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; mso-border-top-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.75pt;" valign="top" width="558"><span style="mso-spacerun: yes;"> </span>

</td></tr><tr style="mso-yfti-irow: 7; height: 14.75pt;"><td style="width: 111.7pt; border: solid black 1.0pt; border-top: none; mso-border-top-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.75pt;" valign="top" width="149">Nome da mãe:<span style="mso-spacerun: yes;"> </span>

</td><td style="width: 418.55pt; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; mso-border-top-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.75pt;" valign="top" width="558"><span style="mso-spacerun: yes;"> </span>

</td></tr><tr style="mso-yfti-irow: 8; height: 14.9pt;"><td style="width: 111.7pt; border: solid black 1.0pt; border-top: none; mso-border-top-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.9pt;" valign="top" width="149">Endereço:<span style="mso-spacerun: yes;"> </span>

</td><td style="width: 418.55pt; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; mso-border-top-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.9pt;" valign="top" width="558"><span style="mso-spacerun: yes;"> </span>

</td></tr><tr style="mso-yfti-irow: 9; height: 14.75pt;"><td style="width: 111.7pt; border: solid black 1.0pt; border-top: none; mso-border-top-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.75pt;" valign="top" width="149">Cidade:<span style="mso-spacerun: yes;"> </span>

</td><td style="width: 418.55pt; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; mso-border-top-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.75pt;" valign="top" width="558"><span style="mso-spacerun: yes;"> </span>

</td></tr><tr style="mso-yfti-irow: 10; height: 14.75pt;"><td style="width: 111.7pt; border: solid black 1.0pt; border-top: none; mso-border-top-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.75pt;" valign="top" width="149">CEP:<span style="mso-spacerun: yes;"> </span>

</td><td style="width: 418.55pt; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; mso-border-top-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.75pt;" valign="top" width="558"><span style="mso-spacerun: yes;"> </span>

</td></tr><tr style="mso-yfti-irow: 11; height: 14.9pt;"><td style="width: 111.7pt; border: solid black 1.0pt; border-top: none; mso-border-top-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.9pt;" valign="top" width="149">Estado:<span style="mso-spacerun: yes;"> </span>

</td><td style="width: 418.55pt; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; mso-border-top-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.9pt;" valign="top" width="558"><span style="mso-spacerun: yes;"> </span>

</td></tr><tr style="mso-yfti-irow: 12; height: 14.75pt;"><td style="width: 111.7pt; border: solid black 1.0pt; border-top: none; mso-border-top-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.75pt;" valign="top" width="149">Telefone setor:<span style="mso-spacerun: yes;"> </span>

</td><td style="width: 418.55pt; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; mso-border-top-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.75pt;" valign="top" width="558"><span style="mso-spacerun: yes;"> </span>

</td></tr><tr style="mso-yfti-irow: 13; height: 14.75pt;"><td style="width: 111.7pt; border: solid black 1.0pt; border-top: none; mso-border-top-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.75pt;" valign="top" width="149">Telefone celular:<span style="mso-spacerun: yes;"> </span>

</td><td style="width: 418.55pt; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; mso-border-top-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.75pt;" valign="top" width="558"><span style="mso-spacerun: yes;"> </span>

</td></tr><tr style="mso-yfti-irow: 14; height: 30.95pt;"><td style="width: 111.7pt; border: solid black 1.0pt; border-top: none; mso-border-top-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 30.95pt;" valign="bottom" width="149">Email:<span style="mso-spacerun: yes;"> </span>

<span style="font-size: 6.0pt; mso-bidi-font-size: 11.0pt; line-height: 107%;">(Ex. nome.sobrenome@ifpa.edu.br)</span>

</td><td style="width: 418.55pt; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; mso-border-top-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 30.95pt;" valign="bottom" width="558">\_\_\_\_\_\_\_\_\_\_\_\_ . \_\_\_\_\_\_\_\_\_\_\_\_\_\_@ifpa.edu.br

</td></tr><tr style="mso-yfti-irow: 15; height: 14.75pt;"><td style="width: 111.7pt; border: solid black 1.0pt; border-top: none; mso-border-top-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.75pt;" valign="top" width="149">Email alternativo:<span style="mso-spacerun: yes;"> </span>

</td><td style="width: 418.55pt; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; mso-border-top-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.75pt;" valign="top" width="558"><span style="mso-spacerun: yes;"> </span>

</td></tr><tr style="mso-yfti-irow: 16; mso-yfti-lastrow: yes; height: 14.9pt;"><td style="width: 111.7pt; border: solid black 1.0pt; border-top: none; mso-border-top-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.9pt;" valign="top" width="149">Justificativa:

</td><td style="width: 418.55pt; border-top: none; border-left: none; border-bottom: solid black 1.0pt; border-right: solid black 1.0pt; mso-border-top-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 2.35pt 5.75pt .4pt 5.4pt; height: 14.9pt;" valign="top" width="558"><span style="mso-spacerun: yes;"> </span>

</td></tr></tbody></table>

**<span style="mso-bidi-font-size: 10.0pt; line-height: 221%;"><span style="mso-list: Ignore;">II.<span style="font: 7.0pt 'Times New Roman';"> </span></span></span><u style="text-underline: black;">TERMO DE RESPONSABILIDADE</u>** Comprometo-me a:

<span style="mso-bidi-font-size: 10.0pt; line-height: 112%;"><span style="mso-list: Ignore;">a)<span style="font: 7.0pt 'Times New Roman';"> </span></span></span>Utilizar a senha de acesso de forma secreta, pessoal e intransferível;

<span style="mso-bidi-font-size: 10.0pt; line-height: 112%;"><span style="mso-list: Ignore;">b)<span style="font: 7.0pt 'Times New Roman';"> </span></span></span>Acessar os sistemas informatizados do IFPA e demais recursos da rede somente por necessidade de serviços ou por determinação expressa de superior hierárquico;

<span style="mso-bidi-font-size: 10.0pt; line-height: 112%;"><span style="mso-list: Ignore;">c)<span style="font: 7.0pt 'Times New Roman';"> </span></span></span>Não revelar fora do âmbito profissional fato ou informação de qualquer natureza de que tenha conhecimento por força de minhas atribuições, salvo em decorrência de decisão competente na esfera legal ou judicial, bem como de autoridade superior;

<span style="mso-bidi-font-size: 10.0pt; line-height: 112%;"><span style="mso-list: Ignore;">d)<span style="font: 7.0pt 'Times New Roman';"> </span></span></span>Manter a necessária cautela quando da exibição de dados em tela, impressora ou na gravação de meios eletrônicos, a fim de evitar que deles venham tomar ciência pessoas não autorizadas;

<span style="mso-bidi-font-size: 10.0pt; line-height: 112%;"><span style="mso-list: Ignore;">e)<span style="font: 7.0pt 'Times New Roman';"> </span></span></span>Responder, em todas as instâncias, pelas conseqüências das ações ou omissões de minha parte que possam por em risco ou comprometer a exclusividade do conhecimento de minha senha ou das transações a que tenha acesso.

Declaro estar ciente das disposições acima referentes ao controle de acesso aos sistemas, informações e recursos de informática e das penalidades cabíveis pela não observância dos compromissos assumidos.

**<u style="text-underline: black;">III. ATENDIMENTO DA SOLICITACAO</u><span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; line-height: 107%;"> </span>**

<table border="0" cellpadding="0" cellspacing="0" class="TableGrid align-center" id="bkmrk-data%3A-___%2F___%2F_____-" style="width: 526.2pt; margin-left: -1.45pt; border-collapse: collapse; mso-yfti-tbllook: 1184; mso-padding-alt: 2.1pt 5.75pt 0cm 0cm;" width="702"><tbody><tr style="mso-yfti-irow: 0; mso-yfti-firstrow: yes; height: 34.45pt;"><td colspan="2" style="width: 177.6pt; background: #FDFDFD; padding: 2.1pt 5.75pt 0cm 0cm; height: 34.45pt;" valign="top" width="237">Data: \_\_\_/\_\_\_/\_\_\_\_\_

<span style="mso-spacerun: yes;"> </span>

<span style="mso-spacerun: yes;"> </span>

</td><td style="width: 36.25pt; background: #FDFDFD; padding: 2.1pt 5.75pt 0cm 0cm; height: 34.45pt;" valign="top" width="48"></td><td style="width: 35.4pt; background: #FDFDFD; padding: 2.1pt 5.75pt 0cm 0cm; height: 34.45pt;" valign="top" width="47"></td><td style="width: 35.4pt; background: #FDFDFD; padding: 2.1pt 5.75pt 0cm 0cm; height: 34.45pt;" valign="top" width="47"></td><td style="width: 241.55pt; background: #FDFDFD; padding: 2.1pt 5.75pt 0cm 0cm; height: 34.45pt;" valign="top" width="322"></td></tr><tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes; height: 45.95pt;"><td style="width: 35.4pt; padding: 2.1pt 5.75pt 0cm 0cm; height: 45.95pt;" valign="top" width="47"></td><td style="width: 142.2pt; background: #FDFDFD; padding: 2.1pt 5.75pt 0cm 0cm; height: 45.95pt;" valign="top" width="190">\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

<span style="mso-spacerun: yes;"> </span>Ass. do usuário <span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>

<span style="mso-spacerun: yes;"> </span>

<span style="mso-spacerun: yes;"> </span>

</td><td style="width: 36.25pt; background: #FDFDFD; padding: 2.1pt 5.75pt 0cm 0cm; height: 45.95pt;" valign="top" width="48"><span style="mso-spacerun: yes;"> </span>

<span style="mso-spacerun: yes;"> </span>

</td><td style="width: 35.4pt; background: #FDFDFD; padding: 2.1pt 5.75pt 0cm 0cm; height: 45.95pt;" valign="top" width="47"><span style="mso-spacerun: yes;"> </span>

<span style="mso-spacerun: yes;"> </span>

</td><td style="width: 35.4pt; background: #FDFDFD; padding: 2.1pt 5.75pt 0cm 0cm; height: 45.95pt;" valign="top" width="47"><span style="mso-spacerun: yes;"> </span>

<span style="mso-spacerun: yes;"> </span>

</td><td style="width: 241.55pt; background: #FDFDFD; padding: 2.1pt 5.75pt 0cm 0cm; height: 45.95pt;" valign="top" width="322"><span style="mso-spacerun: yes;"> </span>\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_<span style="mso-spacerun: yes;"> </span>Ass. do chefe setor (Com Carimbo)

</td></tr><tr><td style="border: none;" width="47">  
</td><td style="border: none;" width="190">  
</td><td style="border: none;" width="48">  
</td><td style="border: none;" width="47">  
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<span style="font-size: 11.0pt; line-height: 107%; font-family: 'Calibri',sans-serif; mso-fareast-font-family: Calibri;"><span style="mso-tab-count: 1;"> </span></span>Ass. do cadastrador<span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span><span style="font-size: 11.0pt; line-height: 107%; font-family: 'Calibri',sans-serif; mso-fareast-font-family: Calibri;"><span style="mso-spacerun: yes;"></span></span>