AI Use Case Proposal Form

How to use this document

• What it is for. It is the single front door for anyone at [ORGANIZATION NAME] to propose a new use of AI or the extension of an existing one. It fits on one page and requires no technical knowledge.
• Who should own it. The AI lead publishes it, receives proposals and performs triage.
• Decisions to take first. Decide where it is published (intranet, electronic form, email [AI GOVERNANCE EMAIL]) and in which tool proposals are kept.
• Fields to complete. Before publishing, replace [ORGANIZATION NAME] and [AI GOVERNANCE EMAIL]. The rest is completed by the proposer (Parts A and B) and the AI lead (Part C).
• What happens next. The proposal enters the "Proposed" state, feeds the "AI Use Case Portfolio" and, if approved, the "AI System Inventory."
• Country variants. None.
• Review and approval. The AI lead approves it together with the "AI Governance Operating Model" and reviews it every year.

AI Use Case Proposal Form

Use this form to propose a new use of AI, a new tool or a significant change to an approved use (another purpose, other data, another vendor or another group of affected people). It is not needed for approved tools used as intended. Answer in your own words; if you do not know an answer, write "don't know." Send it to [AI GOVERNANCE EMAIL].

Part A. Who is proposing

Field	Answer
Name and team	[COMPLETE]
Head of the sponsoring function	[COMPLETE]
Date	[DATE]

Part B. The use case

No.	Question	Answer
B1	What problem do you want to solve or which task do you want to improve?	[COMPLETE]
B2	What would the AI do, in one or two sentences?	[COMPLETE]
B3	What benefit do you expect and how would you measure it? (time, cost, quality, revenue, service)	[COMPLETE]
B4	Who would use it and roughly how many people?	[COMPLETE]
B5	Which tool or vendor do you propose, if you know? Is it already approved?	[COMPLETE]
B6	How would it be used? Tick what applies: ☐ inside an application we buy (P1) ☐ connected through an API to our systems or documents (P2) ☐ a model installed on our servers or cloud (P3) ☐ we would train or fine-tune a model (P4) ☐ an agent that acts on its own in systems (sends, buys, changes records) (P5) ☐ don't know
B7	What data would it use? Tick what applies: ☐ public ☐ internal, non-confidential ☐ confidential company data ☐ customer data ☐ personal data ☐ health, biometric or other special-category data ☐ children's data ☐ don't know
B8	Would the output be used to decide about people (hire, evaluate, grant credit or services, set prices)? ☐ Yes ☐ No ☐ Don't know
B9	Would customers or the public see or receive it (chatbot, published content, automated replies)? ☐ Yes ☐ No
B10	Would a person review each output before it is used? ☐ Always ☐ Sometimes ☐ Never
B11	Estimated annual cost (licenses, consumption, implementation), if known	[COMPLETE]
B12	Is there a deadline or a reason for urgency?	[COMPLETE]
B13	Is it already in use, even as a test? ☐ Yes ☐ No. If so, since when and by whom	[COMPLETE]

I declare that the information is correct to the best of my knowledge and that I will not use the tool with company data until I receive an answer, unless it is already approved for that use.

Signature: [COMPLETE]