Web editionSource revision 7a69074

Blank Agent Delegation Canvas

Print in landscape orientation. Use the completion guide and incorporate supporting schedules before signing.

Figure A1Agent Delegation CanvasBlank form · use with the completion guide

A Mandate Who authorizes what, and for how long?

Purpose / requested scope / exclusions:

Principal / accountable owner / agent configuration:

Ratifier / authority basis:

Start / expiry / timezone / duration rationale:

Affected people / consequence tolerances / reasons:

Resources / availability / confirming owner:

B Actions and human support What is permitted and feasible?

Proposed permissions: authorized / prohibited / pilot only. Omission grants none.

Action / object / destination	Permission / limits	Required human support

Support: prerequisites, affected parties, consequences, recourse access / owner / response time.

Human duty / dependency	Qualified person / effort	Available / window / deadline

Joint allocation and decisive calculation:

Show demand/effort bounds, adequate performance, competing work, shared reserves and continuing duties. Name pause thresholds/delays. A cap alone does not prove feasibility.

C Capabilities and controls

Inspect independently of Canvas Section B. Include unmatched capabilities and alternate/unknown routes.

Actual capability / permitted or unmatched action:

What was checked / by whom / when / coverage:

Control / owner / required human work / unknowns:

Residual exposure / accepted bound / basis:

Disposition: authorized / blocked / contained / unresolved

Reasons / missing check / responsible owner:

D Decision and reconsideration Assess the request first; record alternatives and justify reused findings.

Selected scope / changes from request / alternatives:

Supporting attachments if needed: title / date, or none:

1. Legitimacy and specificationmet / not met · reason: ___________________

2. Consequence and recoursemet / not met · reason: ___________________

3. Capability-controlmet / not met · reason: ___________________

4. Operational responsibility and reconsiderationmet / not met · reason: ___________________

Outcome (select one): authorize the stated scope / pilot only / remediate / do not delegate

Reasons / accepted exposure / implementation owner:

Change triggers / pause owner / restoration checks:

Pilot question or repair / owner / reassessment:

Ratifier signature / date (or unsigned):

Permission needs all four checks met, pilot requirements if applicable, and signed, effective scope with prerequisites satisfied. Missing support is not met. Unsigned, remediate and do not delegate grant no authority. Expiry requires fresh checks and ratification. Include necessary attachments in the signed scope.