Wage and Investment Request for Organizational Change (W-ROC Form), continued on second pageThree columns: Originator Name (fill in)Position/Title (fill in)Org. Symbols (fill in)Below, two columns: E-Mail Address (fill in)Telephone (fill in)Three columns: Contact Point Name (fill in)Position/Title (fill in)Org. Symbols (fill in)Below, two columns: E-Mail Address (fill in)Telephone (fill in)Approval/ConcurrenceThis portion of the form includes 5 columns: Category; the first segment is for Category ATitle, including fill in for the first row for Originating Operating Unit Director (approve), followed by, Chief, Finance (concur), Director, Human Capital Office (concur), Director, Strategy & Finance (concur)Concur (fill in)Approve (fill in)Signature/Date (fill in)Category; the second segment is for Category BTitle, including fill in for the first row for Originating Operating Unit Director (concur), followed by, Chief, Finance (concur), Director, Human Capital Office (concur), Director, Strategy & Finance (concur), W&I Commissioner (approve)Concur (fill in)Approve (fill in)Signature/Date (fill in)Category; the third segment is for Category CTitle, including fill in for the first row for Originating Operating Unit Director (concur), followed by, Chief, Finance (concur), Director, Human Capital Office (concur), Director, Strategy & Finance (concur), W&I Commissioner (concur), IRS Commissioner (approve)Concur (fill in)Approve (fill in)Signature/Date (fill in)Required Attachments Current Org ChartProposed Org ChartMission and Functional statements of impacted units and functionsSummary of Change (see appendix B) (Optional)Cost/Benefit AnalysisNote: Refer all questions to Workforce Organization and Transition, Workforce Design Team. For detail procedures, roles and responsibilities see IRM 1.55.2. Use e-trak to submit the entire request for organizational change; this is also a vehicle to keep all vested parties abreast of the status.