The purpose of this form is to identify computer data files that might need to be modified to be compatible with dates in the 21st century. Complete a separate form for each computer.

Computer Location________________________ User of this Computer___________________ Make/Model________________
Department ____________________________________________________________________  Date____________________
Coordinator/Preparer ______________________________________________ Phone/E-Mail ____________________________

List all databases and data files read by, or processed on this computer. Include files and tables used by packages such as Access, dBase, Enable, FoxPro, Paradox, DB2, etc.; spreadsheets; or attach a directory listing with the information requested below. Attach additional sheets as needed. The last column may be used to check off Year 2000 readiness in Step 2 (Evaluation).

Database/Data File	Application/ Vendor	Are Dates Used? (Y/N)	This Data is Used for	Year 2000 Compliant? (Y/N)