AI Use Case Intake & Approval Procedure
Routes each proposed AI use case through risk assessment, approval and registration before use.
Available soon
- Format
- Word
- Size
- 77 KB
- Length
- 28 pages
- Version
- 1.1
- Updated
What's inside
- Purpose
- Legal note
- Scope
- Roles
- The seven stages
- Stage 1 (IS-1): Propose
- Stage 2 (IS-2): Screen
- Stage 3 (IS-3): Assess
- Stage 4 (IS-4): Decide
- Holds and conditions
- Stage 5 (IS-5): Record
- Stage 6 (IS-6): Enable
- Stage 7 (IS-7): Review
- A use found already running without approval
- Records and incidents
- Decisions and who takes them
- Worked intake cases
- Worked example: the distributor's September 2026 intake record
- Related documents
- Adapting this template
- Framework references
- Definitions
What changed
- 1.1
Hold H-2 applies to Internal data as well as Confidential: either goes in only under a contract term that bars the supplier from training on it, and a setting verified off does not clear the hold. The worked cases and the example's warehouse forecasting module follow it.
- 1.0
Published.
Preview
The document from section 1, as you will receive it. Highlighted [[text]] is for you to replace; shaded guidance boxes are for you to delete before approval. The cover and document control pages are in the file.
Purpose
This procedure sets out how [[Organisation Name]] decides whether an AI use may start. A person proposes the use. The AI governance lead screens it. Some uses need an assessment and a senior decision. Every decision is recorded, and every approval comes up for review on a date.
It runs the intake rules of the AI Acceptable Use & Security Policy. It reads the answers to twelve questions, sets a tier, names who decides, and lists the conditions and holds that follow. It also says what to do with an AI use that is already running and was never approved.
Most organisations do not build AI. They use other people's AI: an assistant inside the office suite, a forecasting feature in a system they already run, a chatbot a supplier offers, or a free tool a member of staff finds on their own. Governing that use proportionately starts with knowing what is in use. For each use, the organisation then decides what data it may touch, who answers for it and how much checking it needs. A small use with low-risk data needs a short screen and a named owner. A use that touches Confidential data, faces customers, acts on its own or helps decide something about a person needs an assessment and a senior decision first. A few uses are never allowed. The result is a list the organisation keeps, with counts of what is approved, held, declined and due for review. It is never one score.
Guidance — delete before approval
Replace every value in [[double brackets]] before approval, and name roles, not people.
The settings in [[double brackets]] (days to screen, days to decide, months between reviews, days to stop an unapproved use) are shared with the AI Acceptable Use & Security Policy. Change them there and here together.
Start with the questions in Stage 1. If a manager can answer them for a simple use without help, the procedure is working. If they cannot, shorten the form and keep the screen as it is.
Legal note
This document helps you govern the AI your organisation uses. It is not legal advice, and following it is not a statement that you comply with the EU AI Act, the GDPR or any standard. Whether the Act binds you, in which role, and which of its duties apply to each system depends on the facts and on how your Member State applies the Act: confirm it with counsel.
This procedure routes a request. It does not decide whether a system is prohibited, high-risk or subject to a transparency duty, and it does not decide which role the organisation holds under the EU AI Act. Where a request might touch those questions, the screen sends it to Legal, and Legal confirms the reading.
Regulation (EU) 2024/1689 binds the operators of its Article 2(1): providers, deployers, importers, distributors, product manufacturers and authorised representatives. An organisation that uses another party’s AI system under its own authority for its business is a deployer (Article 3(4)). An organisation that sells goods and is called a distributor in its trade is not an AI Act distributor unless it makes an AI system available on the Union market (Article 3(7)). Which role an organisation holds for each system depends on the facts, and counsel confirms it.
Scope
This procedure applies to every proposed AI use: a new tool, a new feature switched on in software already in use, a new purpose for a tool already approved, and a new kind of data or audience for an approved use. It also applies to a use found already running without an intake decision. An AI use is one way the organisation uses an AI system, for one purpose, with one owner.
It does not set the rules of use. Those are in the AI Acceptable Use & Security Policy, which this procedure cites by the IDs AG-01 to AG-22. The assessment, the approved list and the inventory are separate documents (AI Use Case Risk & Impact Assessment, AI Tool Approval & Data Permission Matrix, AI System & Use Case Inventory). It does not decide whether an event is a security incident. That is the incident response pack (P09).
Roles
Role | What they do in this procedure |
|---|---|
AI governance lead [[e.g. Head of Risk]] | Owns the AI policy and the approved list, screens every proposed use, keeps the inventory, approves Tier 1 uses and Tier 2 uses (with the Head of Information Security), may suspend an approved running use pending review, advises on Tier 3 and reports the measures. |
AI use owner [[the manager accountable for the business activity the AI supports]] | Proposes the use, answers the intake questions, answers for its output, names the people who check it, is consulted on the decision and signs the conditions it accepts, and asks for a review when anything changes. Never approves a use it owns. |
Head of Information Security [[e.g. Head of Information Security]] | Assesses the security factor, agrees the tool's conditions and approves Tier 2 uses with the AI governance lead. |
Data Protection Officer [[or the privacy lead where no DPO is appointed]] | Advises on personal data in any use, decides with the use owner whether a data protection impact assessment is needed, and is consulted on every use of personal data. |
Legal [[in-house or external counsel]] | Confirms the AI Act role and category of each system, reads supplier terms, and decides whether the organisation could be a provider. |
HR [[e.g. HR Business Partner]] | Advises on any use that touches recruitment, pay, performance or monitoring of staff, and on telling and consulting staff or their representatives. |
Procurement [[e.g. Procurement Manager]] | Makes sure no AI tool or AI feature is bought or switched on without an intake decision, and puts the AI terms into the contract (ST-1 to ST-8). |
System owner [[the manager accountable for the system]] | Owns the system an AI feature sits in, and tells the AI governance lead when a supplier adds or changes an AI feature. |
Head of IT [[e.g. Head of IT]] | Connects approved tools to single sign-on, applies the tool's settings and keeps the technical list of what is installed. |
Executive decision-maker [[e.g. Executive Committee, or the management body]] | Decides Tier 3 uses: executive management by default, or the board where the governance structure puts it. Signs as well for a High risk outside appetite (P05). Does not accept a Critical risk as executive management: it goes to the board or its equivalent (P05 RM-04). |
Line manager [[each person's manager]] | Gives time for the literacy plan, checks that the team uses only approved tools, and sends proposals to the use owner. |
Awareness lead [[e.g. Information Security Manager]] | Runs the literacy modules and keeps the completion record, with the learning system. |
User [[everyone who uses an AI tool for work: staff, contractors and supplier staff]] | Uses only approved tools within their data limits, checks the output, discloses AI use where the policy says, and reports mistakes. |
The AI governance lead approves Tier 1 uses. For Tier 2 the approvers are the AI governance lead and the Head of Information Security, and for Tier 3 the executive decision-maker your procedure names (executive management by default; the board or its equivalent where your governance structure puts it). Nobody approves a use they own: the AI use owner is consulted and signs the conditions it accepts. Where a tier's approver owns the use (the AI governance lead, or the Head of Information Security), the executive decision-maker takes that approver's place.
The seven stages
Every request goes through the same seven stages. A Tier 1 use passes through them in a few days. A Tier 3 use takes longer, and has more people in it.
Stage | What happens | Who | Rule |
|---|---|---|---|
IS-1 Propose | The AI use owner fills in the intake questions (IQ-01 to IQ-12) for the tool, the feature or the use, before buying, switching on or trying it with real data. | AI use owner | AG-09 |
IS-2 Screen | The AI governance lead screens the answers within [[5]] working days of a complete request: prohibited or special category data (Stop), provider signals, then the tier. | AI governance lead | AG-09 |
IS-3 Assess | At Tier 2 and Tier 3, assess the six factors on the risk and impact assessment (A06). Get the supplier's decision under the third-party pack where Internal or Confidential data is involved, or the use is Tier 2 or 3. The Data Protection Officer advises where personal data is used. | Head of Information Security | AG-11 |
IS-4 Decide | The approvers of the tier decide: Approve, Approve with conditions, Hold or Decline. Any approver may hold or decline. Only the tier's approvers may approve, and nobody approves a use they own: the use owner is consulted and signs the conditions it accepts. Where a tier's approver owns the use (the AI governance lead, or the Head of Information Security), the executive decision-maker takes that approver's place. Tier 3 goes to the executive decision-maker the procedure names. If the executive decision-maker owns a Tier 3 use, the board or its equivalent decides it (D-42). | The approvers of the tier | AG-09 |
IS-5 Record | Enter the use in the inventory (A05) with its tier, approver, conditions and review date. Update the approved list (A07) and the supplier register if a supplier is involved. | AI governance lead | AG-10 |
IS-6 Enable | Connect the tool to single sign-on, apply its settings, and give access only to people who have done the AI essentials module (A09, AL-01). Procurement adds the AI terms ST-1 to ST-8 to the contract. | Head of IT | AG-18 |
IS-7 Review | Review at the tier's interval, and within [[10]] working days of a trigger: a new purpose, data or audience, a supplier change, an incident, or a change in law. An unapproved use found is stopped within [[3]] working days. | AI use owner | AG-10 |
Stage 1 (IS-1): Propose
AG-09 No new AI use, and no new AI feature switched on in software already in use, starts before an intake decision under A03. Every decision is recorded in the inventory (A05). Nobody approves a use they own: the use owner is consulted and signs the conditions it accepts, and where a tier's approver owns the use the executive decision-maker takes that approver's place. If the executive decision-maker owns a Tier 3 use, the board or its equivalent decides it (D-42). A use found already running is recorded at the tier its answers give; at Tier 2 or 3 it gets its assessment within [[90]] calendar days of the inventory closing.
In practice. Fill in the intake form [[form or ticket template]] with an answer to each of the twelve questions. Answer from what the tool does with your data, not from the sales page. Attach the supplier's documents, a screenshot of the data and sharing settings, and the name of the person who will read the output. Do this before you buy the tool, switch the feature on or try it with real work data. Record: The completed intake form.
The owner answers these twelve questions in writing:
ID | Question |
|---|---|
IQ-01 | What is the use, in one sentence, and what does the business gain? |
IQ-02 | Which tool or feature, from which supplier (the P06 reference, or none)? Is it already running? What do the supplier's assessment, contract and processor terms say? |
IQ-03 | Which manager is the AI use owner, and who reads the output before it is used? |
IQ-04 | What is the highest level of information that goes in (P15)? |
IQ-05 | Could special category personal data go in (health, trade union membership, biometric data and the others of GDPR Article 9)? |
IQ-06 | Could any personal data go in or come out? |
IQ-07 | Do customers or the public deal with the system, or see its output directly, or does a person review anything that leaves the organisation? |
IQ-08 | Does a person read every output before it is used, or does the system act or send output on its own? |
IQ-09 | Does the use inform a decision about a person, or decide or shape one (recruitment, pay, performance, discipline, credit, access to a service)? A use that decides or shapes one is Tier 3; a use that only informs one is Tier 2. |
IQ-10 | If the output were wrong or the tool stopped, would a core service or a material sum be affected (more than P05's Minor level in any impact area)? |
IQ-11 | Does the use match, or might it match, any practice on the prohibited-practice checklist (A08, PP-01 to PP-10), or fall in an area of Annex III (A08, HA-1 to HA-8)? |
IQ-12 | Would the organisation build an application or feature on a supplier's model API (prompts, retrieval, tools or code around a model it calls), whether for staff or for customers, fine-tune for others, brand, sell or supply the system, or change what it is meant for? Using a supplier's finished product as supplied is not building. Is it already running? |
Attach this evidence to the form:
- IQ-02. The supplier's P06 reference and decision, the contract or terms of use, and the processor terms if personal data goes in.
- IQ-03. The name of the owner's role and of the role that reads the output, and that role's authority to reject it.
- IQ-04. An example of the most sensitive item that would go in, and its marker under P15.
- IQ-07. Where customers or the public would see the output, and what tells them it came from an AI system.
- IQ-11. A tick against each item of the prohibited-practice list and the Annex III areas the use might touch, or a line saying none do.
The answer to IQ-04 is one of Public, Internal and Confidential, the levels of the classification rules (P15). For IQ-05 to IQ-06 and IQ-12 the answer is yes or no. Answer IQ-12 Yes when the feature is built on a supplier's model API (prompts, retrieval, tools or code around a model the organisation calls), whether it is for staff or for customers. Using a supplier's finished product as supplied is not building, so the answer is No. A Yes is a signal for Legal and not a finding that the organisation is a provider. If the requester does not know an answer, the owner finds out before submitting.
Guidance — delete before approval
Most tools are used by many people for several things. Propose one use at a time: one purpose, one owner, one set of data. The same tool for a second purpose is a second use. It usually passes the screen faster than the first because the supplier is already assessed.
Stage 2 (IS-2): Screen
The AI governance lead screens the request within [[5]] working days of receiving a complete form. The screen sets one of four results: Stop, Tier 1, Tier 2 or Tier 3. The method is the same each time, so two people given the same answers reach the same result.
The order of the screen
Step | What the lead does | What follows |
|---|---|---|
S-1 | Check the request is complete and the owner is a manager who answers for the use. | Return it if not. |
S-2 | Check for a prohibited practice and for special category data. | Either one is a Stop. Do not go further. Tell Legal for a prohibited practice, and tell the Data Protection Officer for special category data. |
S-3 | Check for a provider signal (a build on a supplier's model API counts) and for an Annex III area. | Tell Legal. A new use is Tier 3 and held until Legal records which role the organisation holds. If the role is deployer, the tier is then set again from the answers. If it is provider or other, the hold clears and the use stays Tier 3. A use already running carries H-4 as a condition with a date. |
S-4 | Set the tier from the answers, taking the highest tier any trigger gives. Record every trigger that applied, with its rule, not only the highest. | The tier is set. |
S-5 | List the holds that apply to a new use (H-1 to H-4), or the dated conditions that take their place for a use already running. | A hold stops the start. A dated condition does not. |
S-6 | List the assessments, the baseline conditions and the approvers the tier needs, and tell the use owner what happens next and when. | The screen is recorded. |
Stop
A Stop is a result with no route to approval under this procedure. A request is a Stop in two cases.
AG-05 The practices that Article 5 of the EU AI Act prohibits are never allowed, in any use, whoever supplies the tool. They include inferring the emotions of staff at work, scoring people on social behaviour, and generating intimate images of a real person without consent. The checklist is PP-01 to PP-10. Staff also never use AI to impersonate a person, to get around a security control, or to write malware.
AG-03 Follow the classification: Public information with no personal data in it into any tool; Internal only into a tool approved for Internal; Confidential only into a tool approved for Confidential; special category personal data never (P15 CL-14, CL-19). Personal data goes only into a tool approved for personal data, under processor terms (P06 clause CL-06), whatever the level of the information around it: personal data inside Public information does not go into just any tool. A collection, export or copy takes the highest level of anything in it (P15 CL-13).
Tell the requester at once and in plain words which of the two applies. Say what would have to change. A use that changes so that no special category data goes in is a new request. A use that matches a prohibited practice cannot be changed into a permitted one by rewording the form. Legal decides whether anything further is needed.
The tiers
The tier is the highest tier any trigger gives. Record every trigger that applied, with its rule, because the approvers need to see all the reasons and not only the strongest.
Result | Trigger |
|---|---|
Stop | The request ticks any prohibited practice (PP-01 to PP-10). |
Stop | Special category personal data could go in. |
Tier 3 | The request falls in an Annex III area (HA-1 to HA-8). |
Tier 3 | The use decides or shapes a decision about a person. |
Tier 3 | The system acts, or sends output, without a person reading it first. |
Tier 3 | The organisation would build an application or feature on a supplier's model API, brand, supply or change the purpose of the system, the use is new, and Legal has not yet recorded the role. |
Tier 3 | The same, but Legal has recorded the provider role or another role: H-4 clears as a hold, and the use stays Tier 3 (the deployer role sets the tier again from the answers). |
Tier 2 | Confidential information could go in. |
Tier 2 | Any personal data could go in or come out. |
Tier 2 | Customers or the public deal with the system or see its output. |
Tier 2 | The use informs a decision about a person. |
Tier 2 | A wrong output or a stoppage would affect a core service or a material sum. |
Tier 1 | None of the above: Public or Internal information with no personal data, staff only, a person reads every output, no effect on a person, and a low operational effect. |
What each tier needs, who decides, and how long the decision may take after the file is complete. The times and review intervals are house defaults:
Tier | What the use needs | Who decides | Decision within | Review every |
|---|---|---|---|---|
Tier 1 | A screen against the intake questions. No assessment. | AI governance lead | [[5]] working days | [[12]] months |
Tier 2 | The risk and impact assessment (A06), the supplier decision under P06 where a supplier is involved, and the Data Protection Officer's advice where personal data is used. | AI governance lead and Head of Information Security, with the use owner consulted (the owner signs the conditions it accepts and does not approve) and the Data Protection Officer's advice recorded where personal data is used | [[15]] working days | [[6]] months |
Tier 3 | Everything in Tier 2, the EU AI Act worksheet (A08) confirmed by Legal, a data protection impact assessment where Article 35 of the GDPR applies, and HR where staff are affected. | The executive decision-maker your procedure names (executive management by default; the board or its equivalent where your governance structure puts it), on the AI governance lead's recommendation | [[30]] working days | [[6]] months |
The AI governance lead advises on Tier 2 and recommends on Tier 3. Any approver may hold or decline. Only the approvers named for the tier may approve.
AG-06 No AI output decides, alone, a matter that affects a person's job, pay, discipline, credit, access to a service or legal position (GDPR Article 22). A named person makes the decision after reading the evidence. A use that decides or shapes such a decision, or that falls in an area of Annex III of the EU AI Act whatever it does, is Tier 3 and is not started before the Tier 3 decision. A use that only informs such a decision is Tier 2.
AG-16 An AI system that can act on its own (send messages, change records, approve or release payments, run commands) is Tier 3 until assessed. It runs under a named identity with the least access it needs, and it never releases a payment or changes supplier bank details.
AG-17 Nobody builds an application or feature on a supplier's model API (prompts, retrieval, tools or code around a model the organisation calls), whether for staff or for customers, fine-tunes for others, brands, sells or supplies an AI system to a third party, or puts the organisation's name on a supplier's AI system, without Legal's decision first. Using a supplier's finished product as supplied is not building. Building can make the organisation a provider (EU AI Act Articles 3(3) and 25), so Legal records which role the organisation holds before the use starts. A new use is Tier 3 until then. When Legal records the deployer role the tier is set again from the answers; when Legal records the provider role or another role the use stays Tier 3, because it is outside this policy's deployer governance. A use already running carries the hold as a condition with a date.
Stage 3 (IS-3): Assess
AG-11 A supplier of an AI tool, or of software with an AI feature, is assessed under the third-party pack before it receives Internal or Confidential data, and before a Tier 2 or Tier 3 use of it starts even with Public data (P06 TP-01, TP-05; P15 CL-16 asks for it for Confidential data only), and again on a material change (P06 TP-09). The contract carries the AI terms ST-1 to ST-8. A supplier that adds an AI feature gives notice (P06 clause CL-20), and the feature goes through intake before it is switched on.
A Tier 1 use has no assessment. A Tier 2 or Tier 3 use has the AI Use Case Risk & Impact Assessment, and the other items the tier needs. The Head of Information Security leads the assessment with the AI use owner.
The assessment
The assessment rates six factors, RF-1 security, RF-2 privacy, RF-3 fairness, RF-4 safety, RF-5 operational and RF-6 legal and contractual. Each is rated on the organisation's own impact and likelihood scales (P05), before and after the controls. The result is a count of factors by band, never a score. The assessment document holds the question for each factor.
The highest band after controls sets a floor for the tier. A High band needs at least Tier 2. A Critical band, or any physical safety impact, needs Tier 3. If the assessment gives a higher tier than the screen did, the higher tier applies and the screen is repeated.
The other items
- The supplier. Where Internal or Confidential data goes in, the supplier needs a documented decision under the third-party pack (P06) of Approve or Approve with conditions. If there is none, hold H-1 applies (P06 TP-01, TP-05).
- The Data Protection Officer. Where personal data goes in or comes out, the Data Protection Officer's advice is recorded. The Data Protection Officer and the use owner decide together whether a data protection impact assessment is needed (GDPR Article 35). Tier 3 needs one where Article 35 applies.
- Legal. A Tier 3 use has its row in the EU AI Act Role & Risk Classification Worksheet, with the organisation's own reasoning, and Legal's confirmation before the Tier 3 decision. The row records reasoning against the text. It does not classify the system. A use held at H-4 because the answer to IQ-12 is Yes stays held until Legal records which role the organisation holds (deployer, provider or other) with its reasoning in that row. The record is entered in the inventory (A05) with the A08 row and the date of Legal's confirmation (IF-14); without them the role does not clear H-4. H-4 clears, and the screen is run again. If Legal recorded the deployer role, the tier is set from the answers, so it falls to whatever tier the other answers give. If Legal recorded the provider role or another role, H-4 clears as a hold but the use stays Tier 3: the organisation is then outside the deployer governance of this procedure, and the executive decision-maker decides, with the worksheet confirmed by Legal.
- HR. Where staff are affected, HR advises, and tells staff or their representatives where the national rules require it (AG-21).
Stage 4 (IS-4): Decide
The approvers of the tier decide. They have the screen, the assessment where there is one, the supplier's decision and the advice of the Data Protection Officer and Legal. There are four outcomes.
Outcome | Inventory status | What the decision record holds |
|---|---|---|
Approve | Approved | The tier, the approvers, the decision date and the review date. The baseline conditions apply and nothing further. |
Approve with conditions | Approved with conditions | As above, with each further condition written so that someone can check it. A condition with a date is a condition of the approval: the tool is switched off if it is not met. |
Hold | Held | The reason, the hold that is open (H-1 to H-4) and the date it is due to clear. The use does not start. When the hold clears, the approvers decide again. |
Decline | Declined | The reason, in words the requester can act on. The requester may propose again when the reason no longer applies. |
What the decision record holds
- The use ID and the date of each stage.
- The tier, and every trigger that gave it, each with its rule.
- The approvers by name and role, and the date of the decision.
- The outcome, and for a hold or a decline the reason in plain words.
- The baseline conditions that apply, the further conditions, and the date and owner of any dated condition.
- The references of the assessment, the supplier decision, the Data Protection Officer's advice and, for Tier 3, the worksheet row and Legal's confirmation date.
- The review date.
The record is kept with the intake file (AG-12).
Risk outside appetite
If the assessment leaves a factor outside the organisation's appetite for AI risk, the approvers do not approve it as it stands. They reduce the risk, or they send the decision up under the risk management rules (P05 acceptance authorities), or decline. A High risk outside appetite needs executive management to sign as well as the band's approvers. A Critical risk is outside tolerance and goes to the board or its equivalent (P05 RM-04), not to executive management as such. A departure from a rule of the policy is a P02 exception (AG-20), and the prohibitions and the rule on special category data take none.
Holds and conditions
Holds
A hold stops a new use from starting until something is put right. A hold is not a refusal. It names what has to happen and the date by which it should.
Hold | When it applies | What clears it |
|---|---|---|
H-1 | The use has a supplier with no documented decision under the third-party pack yet, and either Internal or Confidential data would go in or the use is Tier 2 or 3 even with Public data (P06 TP-01, TP-05; P15 CL-16 asks for it for Confidential data only, and this procedure asks earlier). A use with no supplier raises no H-1: there is nothing to assess. | The supplier's assessment ends in Approve or Approve with conditions. |
H-2 | Internal or Confidential data would go in, and the contract does not carry a term barring the supplier from training on it (ST-1; P15 CL-19). A setting verified off does not clear it: the supplier can change a setting, and only the contract binds it. | The contract carries the term barring training on the organisation's data. |
H-3 | Personal data would go in, and there are no processor terms (P06 clause CL-06). | Processor terms are signed, and the Data Protection Officer's advice is recorded. |
H-4 | A provider signal is present: the organisation would build on a supplier's model API, brand, supply or change the purpose of the system (AG-17). The signal is not a classification. | Legal records which role the organisation holds (deployer, provider or other), with its reasoning in A08. If the role is deployer, the tier is set again from the answers. If it is provider or other, the hold clears but the use stays Tier 3: the executive decision-maker decides, with A08 confirmed by Legal. |
Where the use is already running, a hold becomes a condition with a date, because stopping a service people rely on may do more harm than carrying on for a short time under control. The approvers set the date. If the date is missed, the tool is switched off. A dated condition is part of the approval itself.
Baseline conditions
Every approved tool carries the baseline conditions that apply to the highest data level it takes. A tool approved only for Public information carries none (P15 CL-19).
ID | What it says | Applies from |
|---|---|---|
BC-1 | Staff sign in with the work account through single sign-on (P13). No personal or free account. A feature built into a service follows that service's own access rules (P07, P13). | Internal and above |
BC-2 | The contract bars the supplier from training on the organisation's data (ST-1; P15 CL-19). Where the tool also has a setting that stops training, it is kept off and checked at each review as an added technical control; it never replaces the contract term. | Internal and above |
BC-3 | The tool and its supplier are in the inventory (A05) and, for Internal and Confidential data, in the supplier register (P06). | Internal and above |
BC-4 | Confidential data and above only after the supplier's documented decision is Approve or Approve with conditions (P06 TP-05; P15 CL-16). | Confidential and above |
BC-5 | Personal data only where the tool is approved for it, under processor terms (P06 clause CL-06). | Public |
BC-5 applies when personal data goes in, at any level. The approved list (A07) records the highest level and whether personal data is allowed for each tool. The approvers add further conditions where the assessment calls for them, each written so that someone else can check it.
Supplier terms
Procurement puts these eight terms into the contract with the supplier of an AI tool, or of software with an AI feature, in Stage 6. The right-hand column gives the clause of the third-party pack's clause library that carries each one. Where the library has no clause, write the term in the contract in the words shown.
Term | What the contract says | Clause in the third-party pack |
|---|---|---|
ST-1 | The supplier does not use our prompts, files or outputs to train or improve its models or anyone else's, and says so in the contract. | None. Write the term in the contract |
ST-2 | The supplier processes personal data only on our documented instructions. | P06 clause CL-06 Data protection: processor terms |
ST-3 | The supplier names the sub-processors it uses, including the provider of the underlying model, and gives notice before it changes them. | P06 clause CL-04 Sub-processors and subcontracting |
ST-4 | The supplier states where prompts, outputs and logs are stored and processed, and gives notice before it changes the locations. | P06 clause CL-05 Locations of service and data |
ST-5 | The supplier notifies us of a security incident that exposes our prompts, outputs, files or accounts. | P06 clause CL-07 Security incident notification |
ST-6 | On exit the supplier returns and deletes our prompts, outputs, logs, uploaded files and any model or index built from our data. | P06 clause CL-13 Data return and deletion |
ST-7 | The supplier gives notice before it adds or changes an AI feature in a service we already use. | P06 clause CL-20 Notice of material changes |
ST-8 | The supplier gives us in writing the intended purpose and instructions for use of the AI system (EU AI Act Articles 3(12) and 3(15)). | None. Write the term in the contract |
ST-1 and ST-8 have no clause in the library. Write them as they stand and ask Legal to read the supplier's own wording. The terms bind the supplier of the tool. They do not decide any role under the EU AI Act. A supplier that will not give ST-1 for Internal or Confidential data leaves hold H-2 open. A setting verified off does not clear it.
Stage 5 (IS-5): Record
AG-10 The inventory lists every use with an owner, a purpose, a tool, the highest data level, a tier, an approver, a status and a review date. Owners review their uses at the tier's interval, and the whole inventory is reviewed at least every [[6]] months. A trigger (A05) forces a review within [[10]] working days. Pending that review the AI governance lead may suspend an approved running use; the approvers of its tier decide whether it resumes.
In practice. Enter the use in the inventory with every field the decision gives. Add the tool to the approved list, or change its row, and add or update the supplier in the supplier register where Internal or Confidential data is involved. Tell the use owner. Record: The inventory row, the approved-list row and the supplier register entry.
The entry goes into the AI System & Use Case Inventory the same day as the decision, and the approved list is the AI Tool Approval & Data Permission Matrix. The inventory checks catch most mistakes at this point: a tier lower than the answers give (IV-05), an approver who is not one of the tier's, or who owns the use (IV-06), a held use with no date for its hold (IV-07), and a Tier 2 or 3 use with no assessment and no due date (IV-08).
Stage 6 (IS-6): Enable
AG-18 Everyone who uses or oversees an AI tool completes the AI essentials module (AL-01) before access is switched on, or within [[60]] calendar days of the plan's launch if they already have access, and refreshes it every [[12]] months. People in the roles of A09 take the role modules. The organisation keeps an internal record of what each person completed. No certificate is needed (EU AI Act Article 4).
In practice. Connect the tool to single sign-on and apply the settings the conditions name. Switch access on for people who have completed the AI essentials module. Procurement puts the supplier terms into the contract. Keep a copy of the settings as they stand on the day the tool goes live. Record: The access list, the settings record and the contract with the supplier terms.
Nothing is switched on before the record is made. The use owner tells the users what the use is for, what data it may take, who reads the output, and how to report a mistake. The line manager checks that the team uses only the approved tool.
Stage 7 (IS-7): Review
In practice. Put the review date in the owner's calendar when the decision is made. At the date, or within the working days a trigger allows, the owner repeats the screen with today's answers and reports to the AI governance lead. The routine follows. Record: The review note and the new review date.
An approval is not permanent. It has a review date, which is the decision date plus the tier's months: [[12]] months for Tier 1, [[6]] for Tier 2 and [[6]] for Tier 3. A review that has passed its date is listed by the inventory check IV-09, and the use is reported as overdue.
What forces an early review
A trigger forces a review of the use within [[10]] working days. The use owner reports any of these to the AI governance lead as soon as they know of it:
- A new purpose, data level or audience
- A change of supplier, model or location, or a new AI feature
- An incident or near miss involving the use
- A complaint about the output
- A change in law, guidance or the organisation's policy
- A person leaving who was the owner or the checker
How a review runs
Step | What happens |
|---|---|
RV-1 | Repeat the twelve intake questions with today's answers and run the screen again. A tier higher than the recorded one is a new decision at the higher tier. |
RV-2 | Check each condition and each dated condition. A condition not met is reported to the approvers, and the tool is switched off if the approval says so. |
RV-3 | Check the supplier: the decision under P06 still stands, no sub-processor or location has changed without notice (ST-3, ST-4), and no new AI feature has been added (ST-7). |
RV-4 | Check the people: who still has access, who checks the output, and whether each has completed the AI essentials module. |
RV-5 | Look at the record of events and complaints about the use since the last review. A mistake that reached a customer, a payment or a person is reported through the incident route (AT-5). |
RV-6 | Confirm, retire or change. A confirmed use gets a new review date from the tier's months. A retired use is closed in the inventory and its access removed. |
The whole inventory is also reviewed at least every [[6]] months (AG-10).
A use found already running without approval
Most organisations find AI uses they did not know about: a free assistant on personal accounts, a feature a supplier added in a release, a tool a team bought with a card. Finding one means the procedure is working. The aim is to make it safe first, then decide whether it can go on.
The steps, in order:
Step | What happens | Who |
|---|---|---|
EX-1 Find it | Uses are found by the inventory survey, the discovery of systems bought with a card or signed into with a work address (P13 JML-12), a supplier's notice of a new AI feature (ST-7), a manager's question or a staff report. Whoever finds it tells the AI governance lead the same day. | AI governance lead |
EX-2 Protect first | Ask the people involved to stop putting in anything above Public. If the use is a Stop (a prohibited practice, or special category data going in), stop it now: do not wait for the working days in the next step. Tell Legal or the Data Protection Officer the same day. | AI governance lead; Data Protection Officer; Legal |
EX-3 Find out what went in | Ask the users what they put in, over what period, through which account. Compare the answer with the approved list. If Internal or Confidential information went into a tool not approved for it, or personal data into a tool not approved for it, report it as an event (AT-1 to AT-3). Nobody is blamed for a report made in good faith (P09 IM-01). | AI governance lead; AI use owner |
EX-4 Decide whether it can go on | Answer the twelve questions as the use runs today, and mark the use as already running. The screen sets the tier as for a new use. A hold becomes a condition with a date. If the tool is not on the approved list, or the use needs data above what the list allows, stop the use within the working days AG-02 sets, and help the people to a tool they may use. | AI governance lead; AI use owner |
EX-5 Approve with dated conditions, or stop | A use that can go on under the tier's approvers is approved with conditions. Write each dated condition with the date and the person who answers for it, and say in the decision that the tool is switched off if the date is missed. A use that cannot go on is Stopped, with its reason. | AI use owner; Head of Information Security; Executive decision-maker |
EX-6 Assess within the transition | At Tier 2 or Tier 3 the assessment is due within the calendar days AG-09 sets after the inventory closed. Enter the due date in the inventory (the inventory check IV-08 looks for it) and keep to it. | Head of Information Security |
The decision method differs for a running use in two ways. A provider signal does not raise it to Tier 3 by itself, although Legal still records the role, and until it does H-4 stands as a dated condition. And a hold is recorded as a dated condition. The tier and the approvers are the same as for a new use. Three cases:
What was found | What follows |
|---|---|
A tool that is not on the approved list, with Internal data going in | Protect first (EX-2). Stop within [[3]] working days (AG-02), report as an event (AT-1), help the people to an approved tool. The use may be proposed afresh. |
An approved supplier added an AI feature to software the organisation already uses | Treat the feature as a new use. Screen it. If it can go on, approve it with conditions and a date for the assessment. |
A use that matches a prohibited practice or takes special category data | Stop it now (EX-2). Legal is told for a prohibited practice. For special category data report at once and tell the Data Protection Officer the same day (AT-3). There is no dated condition. |
AG-02 Use an AI tool for work only if it is on the approved list (A07), and only with data the list allows for it. Public information with no personal data in it may go into any tool (P15 CL-19), but never through a work account and never under the organisation's name. An unapproved use found is stopped within [[3]] working days of discovery, and the people involved are helped to a tool they may use.
Guidance — delete before approval
Do not send an email to everyone asking who uses AI and threatening a penalty. People hide what they do. Ask what they would need from an approved tool, then approve one. People who have an approved tool stop using the free one.
Records and incidents
The intake file holds the form, the screen, the assessment, the decision record, the supplier decision, the advice given, and the notes of every review. A declined or stopped request is kept as well: it shows what was asked, and why the answer was no. Keep it for the period AG-12 sets.
AG-13 Report an AI-related security event or mishandling at once through the incident route (P09 IM-01). The triggers that hand over are AT-1 to AT-8. Nobody is blamed for a report made in good faith. The incident pack decides whether it is an incident and what must be reported, and its clocks apply.
AT-1 to AT-7 apply now. AT-8 applies to a high-risk system from 2 December 2027. The reporting pack holds the duties and the clocks, and this procedure sets none. Screening of every declared incident follows the incident pack (P09 IM-06); the Regulatory Incident Notification & Reporting pack (P18) holds the reporting procedure.
Decisions and who takes them
The AI Governance Responsibility Matrix gives, for each activity of this procedure, the one role that is accountable and the roles that do the work, are consulted and are told. In short: the AI use owner answers for the proposal, the assessment and the output (RS-02, RS-04, RS-12). The AI governance lead answers for the screen and the inventory (RS-03, RS-11). The AI governance lead answers for a Tier 1 or Tier 2 approval, with the Head of Information Security at Tier 2 (RS-05, RS-06), and for suspending an approved running use (RS-15). The AI use owner is consulted on every approval and signs the conditions it accepts, but approves nothing it owns. The executive decision-maker answers for a Tier 3 decision (RS-07), and for a Tier 1 or Tier 2 decision in the place of an approver who owns the use (RS-16), Legal for the reading of the EU AI Act (RS-08) and Procurement for the supplier contract (RS-09).
Worked intake cases
EXAMPLE, not part of the procedure. Nineteen requests, each run through the decision method with the answers shown. Every request starts from the same plain case: Internal information, no personal data, staff only, a person reads every output, no effect on a person, a low operational effect, an approved supplier, a bar on training on the organisation's data and processor terms in place. Each row changes only what the case says. The tier, the holds and the dated conditions are what the method gives.
Case | Request | Result | What follows | Hold or dated condition | Deciding rule |
|---|---|---|---|---|---|
IC-A | Draft and summarise internal text with the approved office assistant | Tier 1 | AI governance lead decides within [[5]] working days. Review every [[12]] months | None | AG-09 |
IC-B | Rewrite a published product description in a free public tool | Tier 1 | AI governance lead decides within [[5]] working days. Review every [[12]] months | None | AG-09 |
IC-C | Staff shift rota summarised, with names | Tier 2 | AI governance lead and Head of Information Security decide within [[15]] working days. Review every [[6]] months | None | AG-03 |
IC-D | Customer price lists compared by an AI tool | Tier 2 | AI governance lead and Head of Information Security decide within [[15]] working days. Review every [[6]] months | None | AG-03 |
IC-E | Confidential contract text, but the supplier has not agreed to bar training | Tier 2 | AI governance lead and Head of Information Security decide within [[15]] working days. Review every [[6]] months | Hold H-2 | AG-03 |
IC-F | Supplier with no assessment yet, Internal data, a new use | Tier 1 | AI governance lead decides within [[5]] working days. Review every [[12]] months | Hold H-1 | AG-11 |
IC-G | The same, but the use is already running | Tier 1 | AI governance lead decides within [[5]] working days. Review every [[12]] months | Dated condition H-1 | AG-11 |
IC-H | A forecast that sets reorder quantities for three warehouses | Tier 2 | AI governance lead and Head of Information Security decide within [[15]] working days. Review every [[6]] months | None | AG-10 |
IC-I | A chatbot that answers customers on its own | Tier 3 | Executive decision-maker decides within [[30]] working days. Review every [[6]] months | None | AG-16 |
IC-J | An assistant that drafts replies for agents to check before sending | Tier 2 | AI governance lead and Head of Information Security decide within [[15]] working days. Review every [[6]] months | None | AG-03 |
IC-K | A tool that ranks job applicants | Tier 3 | Executive decision-maker decides within [[30]] working days. Review every [[6]] months | None | AG-06 |
IC-L | Scoring staff performance from call recordings | Tier 3 | Executive decision-maker decides within [[30]] working days. Review every [[6]] months | None | AG-06 |
IC-M | A video-call tool that reports the mood of the team | Stop | Not started. Legal is told | None | AG-05 |
IC-N | Occupational health notes summarised by an assistant | Stop | Not started. The data protection officer is told; change the use | None | AG-03 |
IC-O | We would sell our own assistant, built on a supplier's model, to customers | Tier 3 | Executive decision-maker decides within [[30]] working days. Review every [[6]] months | Hold H-4 | AG-17 |
IC-P | Staff would use an assistant we build on a supplier's model API, with Internal data (Legal has not recorded the role) | Tier 3 | Executive decision-maker decides within [[30]] working days. Review every [[6]] months | Hold H-4 | AG-17 |
IC-Q | The same assistant after Legal records the deployer role | Tier 1 | AI governance lead decides within [[5]] working days. Review every [[12]] months | None | AG-09 |
IC-R | An assistant we build on a supplier's model API for customers, Legal has recorded the role, and the answers give Tier 2 | Tier 2 | AI governance lead and Head of Information Security decide within [[15]] working days. Review every [[6]] months | None | AG-08 |
IC-S | A feature built on a supplier's model API and already running before the policy, role not yet recorded | Tier 1 | AI governance lead decides within [[5]] working days. Review every [[12]] months | Dated condition H-4 | AG-09 |
IC-T | The same new assistant, but Legal records the provider role: H-4 clears as a hold, and the use stays Tier 3 | Tier 3 | Executive decision-maker decides within [[30]] working days. Review every [[6]] months | None | AG-17 |
IC-U | The same new assistant, but Legal records another role: H-4 clears as a hold, and the use stays Tier 3 | Tier 3 | Executive decision-maker decides within [[30]] working days. Review every [[6]] months | None | AG-17 |
Of the nineteen, 6 are Tier 1, 6 are Tier 2, 7 are Tier 3 and 2 are a Stop.
Four cases read closely
IC-G: The same, but the use is already running
- Public or Internal non-personal data, staff only, a person reads every output, no effect on a person, and a low operational effect. (AG-09)
- Condition with a date H-1: The use has a supplier with no documented decision under the third-party pack yet, and either Internal or Confidential data would go in or the use is Tier 2 or 3 even with Public data (P06 TP-01, TP-05; P15 CL-16 asks for it for Confidential data only, and this procedure asks earlier). A use with no supplier raises no H-1: there is nothing to assess. (AG-11)
Compare IC-F, the same request when the use is new. There the missing supplier decision is a hold, and the use waits. Here the use is already running, so the gap is a condition with a date: the supplier's assessment under P06 must end in Approve or Approve with conditions by the date the approvers set, or the feature is switched off. The tier is the same.
IC-K: A tool that ranks job applicants
- The use falls in an area of Annex III of the EU AI Act (HA-4). It is Tier 3. (AG-06)
- The use decides or shapes a decision about a person (GDPR Article 22; Annex III). (AG-06)
- Confidential information would go in. (AG-03)
- Personal data would go in or come out. (AG-03)
The request ticks Annex III area 4 (HA-4) and decides or shapes a decision about a person, so it is routed to Tier 3. The procedure does not say that the system is high-risk: Legal reads the Act's text on the worksheet and confirms. IC-L, scoring staff performance from call recordings, ticks the same area and reaches the same tier. HR advises before any decision.
IC-M and IC-N: the two Stop cases
- The use may match a prohibited practice (PP-06). It is not started, and Legal is told. (AG-05)
- Special category personal data would go into an AI tool. It never does (P15 CL-19). Change the use so that it does not. (AG-03)
IC-M ticks PP-06, inferring emotions of people at work. The request stops at the screen and Legal is told. IC-N would put occupational health notes, which are special category data, into an assistant. The request stops at the screen. There is no assessment in either case and no route to approval. An alternative that keeps the health notes out of the tool is a new request.
IC-P to IC-U: building on a model API
- Building on a supplier's model API counts as building. That is a signal, not a classification, and Legal records the role (D-51). A new use is Tier 3 until Legal has recorded it. (AG-17)
- Hold H-4: A provider signal is present: the organisation would build on a supplier's model API, brand, supply or change the purpose of the system (AG-17). The signal is not a classification. (AG-17)
A team builds an assistant on a supplier's model API. Staff are the only users and the data is Internal, but the answer to IQ-12 is Yes, because building counts whoever the users are. The request is Tier 3 and held at H-4 (IC-P). Legal records the deployer role, with its reasoning on the worksheet (A08), and the hold clears. The tier is then set again from the answers, and with nothing else raised it is Tier 1 (IC-Q). The Yes was a signal and not a finding, so it does not keep the use at Tier 3. If the assistant were open to customers with Confidential personal data, the same record would leave it at Tier 2 (IC-R). The tier falls only when Legal records the deployer role. If Legal records the provider role (IC-T) or another role (IC-U), H-4 clears as a hold but the new use stays Tier 3, because the organisation is then outside the deployer governance of this procedure: the executive decision-maker decides, with the worksheet (A08) confirmed by Legal. The role counts only when the inventory holds the A08 row and the date of Legal's confirmation. IC-S is the same build found already running: the signal does not raise a running use to Tier 3, and H-4 stands as a dated condition until Legal records the role.
Worked example: the distributor's September 2026 intake record
EXAMPLE, not part of the procedure. The organisation used throughout the pack is a wholesale distributor with about 900 staff and three warehouses, an important entity under NIS2 in its Member State, and not a financial entity, so DORA's reporting duties do not apply. Its Executive Committee approved the AI policy on 11 Aug 2026. The AI governance lead, who is the Head of Risk, runs the intake. An inventory survey ran from 14 Sep 2026 to 25 Sep 2026. Values are as at 30 Sep 2026.
Seven uses through the procedure
Use | Tool | Tier | Requested | Screened | Decided | Outcome | Review due |
|---|---|---|---|---|---|---|---|
AI-001 | Office suite assistant | Tier 1 | 27 Aug 2026 | 1 Sep 2026 3 working days | 2 Sep 2026 4 working days from request | Approved with conditions | 2 Sep 2027 |
AI-002 | Warehouse system forecasting module | Tier 2 | 17 Sep 2026 | 21 Sep 2026 2 working days | 28 Sep 2026 7 working days from request | Approved with conditions | 28 Mar 2027 |
AI-003 | Customer-service chatbot | Tier 3 | 9 Sep 2026 | 11 Sep 2026 2 working days | 29 Sep 2026 14 working days from request | Held Hold due to clear 1 Dec 2026 | None set |
AI-004 | Design tool image generator | Tier 1 | 16 Sep 2026 | 17 Sep 2026 1 working day | 23 Sep 2026 5 working days from request | Approved with conditions | 23 Sep 2027 |
AI-005 | Free public chat assistant | Tier 1 | 18 Sep 2026 | 18 Sep 2026 0 working days | 21 Sep 2026 1 working day from request | Stopped | None set |
AI-006 | Security monitoring service | Tier 2 | 15 Sep 2026 | 21 Sep 2026 4 working days | 28 Sep 2026 9 working days from request | Approved with conditions | 28 Mar 2027 |
AI-007 | Recruitment system ranking add-on (proposed) | Tier 3 | 17 Sep 2026 | 22 Sep 2026 3 working days | 22 Sep 2026 3 working days from request | Declined | None set |
The inventory holds seven uses. 4 of the 7 are approved with conditions, 1 is held, 1 is declined and 1 was stopped. Each decision fell inside the working days the tier allows. 4 of the 5 uses in use or proposed have a current approval; the other is AI-003, which is held. 2 of the 3 Tier 2 and Tier 3 uses that are approved or held have a completed assessment; the other is AI-006. 0 approvals are past their review date.
What each tier looked like
Tier 1: AI-001, the office-suite assistant
Drafting and summarising internal text with the office-suite assistant. Internal information only, staff only, a person reads every output: Tier 1. AI governance lead (Head of Risk) approved it with conditions on 2 Sep 2026, 4 working days after the request, because the supplier was already assessed under P06. The review falls on 2 Sep 2027, 12 months after the decision.
Tier 2, already running: AI-002 and AI-006
AI-002 is demand forecasting inside the warehouse management system. The answers give a material operational effect, so it is Tier 2. It was running as a feature of the supplier's 2025 release, so the missing supplier decision (H-1) became a dated condition and not a hold: the supplier's assessment under P06 (TP-05) must end in Approve or Approve with conditions by 20 Oct 2026, or the module is switched off. Its assessment was completed on 24 Sep 2026, and it was approved with conditions on 28 Sep 2026.
AI-006 is machine-learning anomaly detection in the managed security monitoring service. Confidential information and personal data go in, so it is Tier 2. The provider was assessed under P06, so no hold applies. It was approved with conditions on 28 Sep 2026. Its assessment is due by 24 Dec 2026, 90 days after the inventory closed on 25 Sep 2026. It is the one Tier 2 or Tier 3 use without an assessment today.
Tier 3: AI-003 held and AI-007 declined
AI-003 is a customer-service chatbot, proposed by the outsourced contact centre, that answers order-status questions. Customers talk to it and it acts on its own with their personal data, so it is Tier 3. Three holds apply: H-1, H-2 and H-3. The assessment was done first (23 Sep 2026). The Executive Committee held the use on 29 Sep 2026, 14 working days after the request, inside the 30 the tier allows. The hold is due to clear on 1 Dec 2026.
AI-007 is a job-applicant ranking add-on to the recruitment system, proposed by HR. The answers tick Annex III area 4 and a decision about a person, so the screen gave Tier 3. The lead and the HR Director declined it on 22 Sep 2026, before any assessment, because any approver may decline. They recorded why, and the use can be proposed again.
A stop: AI-005, the free assistant on personal accounts
Not an approved tool. Found in the survey on 18 Sep 2026 and stopped on 21 Sep 2026. The four Marketing users had put draft campaign wording and launch dates (Internal) into it; they confirmed no personal data and no Confidential files. They moved to the approved assistant (AI-001) and completed AI essentials by 28 Sep 2026. That is 1 working day after discovery on 18 Sep 2026, inside the 3 the policy allows. Count: 1 of 1 unapproved use found, stopped in time.
It broke AG-02 and AG-04. It was reported on 18 Sep 2026 as an event through the incident route (P09 IM-01), triaged the same day, and not declared an incident (AT-1). Internal information only: draft campaign wording and launch dates. No personal data, no Confidential files and no special category data, confirmed with the four users the same day. No reporting duty arose.
Related documents
Document | Relationship |
|---|---|
AI Acceptable Use & Security Policy | The rules AG-01 to AG-22 this procedure runs, including the prohibitions and the data rules |
AI System & Use Case Inventory | Where every use and its tier, approver, conditions, holds and review date are recorded |
AI Use Case Risk & Impact Assessment | The assessment for Tier 2 and Tier 3: six factors, rated before and after controls |
AI Tool Approval & Data Permission Matrix | The approved list: each tool's state, data levels and conditions, and the terms to ask of a supplier |
EU AI Act Role & Risk Classification Worksheet | Legal's worksheet for Tier 3 and for any request that might touch an Annex III area or a prohibited practice |
Third-Party Security Risk Management pack (P06) | The supplier assessment (TP-01, TP-05, TP-09) and the contract clauses the supplier terms point to |
Security Incident Management pack (P09) | The incident route (IM-01), the screening of declared incidents (IM-06) and the playbooks |
Adapting this template
Guidance — delete before approval
Small organisation: keep the seven stages but let one person hold several roles. The AI governance lead can be the IT manager, and a single form and a spreadsheet are enough. Keep Tier 1 to a screen of a few minutes, and keep the Stop and the Tier 3 rules exactly as written. Where two roles are one person, a second person reads the decision.
Managed service provider or outsourced IT: if an outsourced IT service provider runs your systems, ask it to tell you before it switches on an AI feature (ST-7) and to give you the supplier terms for its own AI tools. Hold the provider to the same intake decision. The accountability for the decision stays with you.
Regulated entity: a financial entity under DORA, a provider under NIS2, or an organisation that is a high-risk deployer or a public body has duties this procedure does not set. Agree with [[legal or compliance]] which of them apply, and add them to the tier triggers. Do not remove a trigger.
Setting the times: the days to screen and to decide, and the months between reviews, are house defaults. Raise them only if the process is working at the current ones. A longer interval for a risky use is never a saving.
Delete this section before approval.
Framework references
These references show where this document supports an external framework. They indicate relevance only and do not reproduce the text of any standard. Editions referenced: Regulation (EU) 2024/1689 (the EU AI Act) as amended by Regulation (EU) 2026/1744; ISO/IEC 27001:2022 incl. Amd 1:2024; ISO/IEC 42001:2023 (by number and title only); NIST CSF 2.0; NIST AI RMF 1.0; Regulation (EU) 2016/679 (GDPR); as published and read on 8 October 2026.
Framework | Reference | Supported by |
|---|---|---|
ISO/IEC 27001:2022 | Annex A 5.8 — Information security in project management | Stages 1 to 4: information security is considered when a use is proposed and approved, before it starts |
ISO/IEC 42001:2023 | Clause 6.1 — Actions to address risks and opportunities | Stages 2 and 3: actions to address risks and opportunities, by tier |
ISO/IEC 42001:2023 | Clause 6.1.4 — AI system impact assessment | Stage 3: the impact assessment of a Tier 2 or Tier 3 use |
ISO/IEC 42001:2023 | Annex A 5.2 — AI system impact assessment process | Stage 3: the process that decides when and how a use is assessed |
ISO/IEC 42001:2023 | Annex A 9.2 — Processes for responsible use of AI systems | Stages 1 to 7: a defined process for the responsible use of an AI system |
NIST CSF 2.0 | GV.RM-03 — “Cybersecurity risk management activities and outcomes are included in enterprise risk management processes” | Stages 2 to 4: AI risk handled through the organisation's risk management, with the executive decision-maker deciding the highest-risk uses |
EU AI Act — Regulation (EU) 2024/1689 | Article 3(4) — “deployer” means “a natural or legal person, public authority, agency or other body using an AI system under its authority except where the AI system is used in the course of a personal non-professional activity” | Scope and Stage 3: the organisation is looking at the deployer test for the AI it uses |
EU AI Act — Regulation (EU) 2024/1689 | Article 5(1), points (a) to (h) — prohibited, from 2 February 2025: AI that deploys subliminal, purposefully manipulative or deceptive techniques that materially distort behaviour and cause significant harm (a); exploits vulnerabilities due to age, disability or a specific social or economic situation (b); evaluates or classifies people by social behaviour or personal characteristics, with detrimental treatment in unrelated contexts or that is unjustified or disproportionate (c); assesses the risk of a person committing a criminal offence based solely on profiling or personality traits (d); creates or expands facial recognition databases by untargeted scraping of facial images from the internet or CCTV (e); infers emotions in the areas of workplace and education institutions, except for medical or safety reasons (f); categorises people by biometric data to infer race, political opinions, trade union membership, religious or philosophical beliefs, sex life or sexual orientation (g); and, with narrow exceptions, real-time remote biometric identification in publicly accessible spaces for law enforcement (h). Regulation (EU) 2026/1744 adds points (ba) and (bb) (AI that generates or manipulates realistic intimate images of an identifiable person without consent, and AI that generates or manipulates child sexual abuse material), with Article 5(1a) and (1b), from 2 December 2026 | Stage 2: the Stop for a prohibited practice, using the checklist PP-01 to PP-10 |
EU AI Act — Regulation (EU) 2024/1689 | Article 6(2) — in addition to systems that are safety components of products under Annex I, “AI systems referred to in Annex III shall be considered to be high-risk” | Stage 2: an Annex III area sends a request to Tier 3 and to Legal |
EU AI Act — Regulation (EU) 2024/1689 | Article 6(3) — an Annex III system is not high-risk where it “does not pose a significant risk of harm to the health, safety or fundamental rights of natural persons, including by not materially influencing the outcome of decision making”, which applies where it is intended to perform a narrow procedural task, improve the result of a previously completed human activity, detect decision-making patterns without replacing or influencing the human assessment, or perform a preparatory task; “an AI system referred to in Annex III shall always be considered to be high-risk where the AI system performs profiling of natural persons”. The provider documents the assessment before the system is placed on the market (Article 6(4)) | Stage 3: Legal's reading of a request that touches an Annex III area, including profiling |
EU AI Act — Regulation (EU) 2024/1689 | Article 25(1) — a distributor, importer, deployer or other third party “shall be considered to be a provider of a high-risk AI system” and subject to the provider’s obligations where it puts its name or trademark on a high-risk system already on the market, makes a substantial modification to a high-risk system that remains high-risk, or modifies the intended purpose of a system that was not high-risk so that it becomes high-risk under Article 6 | Stage 2: a provider signal (building on a model API, branding, change of purpose) sends the request to Legal first |
EU AI Act — Regulation (EU) 2024/1689 | Article 26(1) — deployers of high-risk AI systems “shall take appropriate technical and organisational measures to ensure they use such systems in accordance with the instructions for use accompanying the systems”. The obligations of Article 26 applies from 2 December 2027 to systems classified as high-risk under Article 6(2) and Annex III, and from 2 August 2028 to those under Article 6(1) and Annex I (Article 113, third paragraph, point (c), as amended by Regulation (EU) 2026/1744) | Stage 3: the deployer duties for a high-risk system that the request might bring |
EU AI Act — Regulation (EU) 2024/1689 | Article 26(7) — before putting into service or using a high-risk system at the workplace, deployers who are employers “shall inform workers’ representatives and the affected workers that they will be subject to the use of the high-risk AI system” | Stage 3: informing workers and their representatives, through HR |
EU AI Act — Regulation (EU) 2024/1689 | Article 26(9) — where applicable, deployers of high-risk systems use the information the provider gives under Article 13 to carry out their data protection impact assessment under Article 35 of Regulation (EU) 2016/679 | Stage 3: the data protection impact assessment, using the provider's information |
EU AI Act — Regulation (EU) 2024/1689 | Article 50(1) — providers ensure that AI systems intended to interact directly with natural persons are designed so that the persons are informed that they are interacting with an AI system, “unless this is obvious from the point of view of a natural person who is reasonably well-informed, observant and circumspect” | Stage 6: telling people that they are dealing with an AI system |
EU AI Act — Regulation (EU) 2024/1689 | Article 113, as amended — the Regulation applies from 2 August 2026, except that Chapters I and II (including Articles 4 and 5) apply from 2 February 2025, with Article 5(1) points (ba) and (bb) and Article 5(1a) and (1b) applying from 2 December 2026; Chapter III Section 4, Chapter V (general-purpose AI models), Chapter VII and Chapter XII and Article 78 apply from 2 August 2025, except Article 101; and Chapter III Sections 1, 2 and 3, except Article 6(5), apply from 2 December 2027 as regards systems classified as high-risk under Article 6(2) and Annex III, and from 2 August 2028 as regards those under Article 6(1) and Annex I. Article 50 is not listed in an exception and so applies from 2 August 2026 | The legal note and the dates: when each part of the Act applies after Regulation (EU) 2026/1744 |
EU AI Act — Regulation (EU) 2026/1744 (Digital Omnibus on AI) | Regulation (EU) 2026/1744 of 8 July 2026 amending Regulations (EU) 2024/1689, (EU) 2018/1139 and (EU) 2023/1230 as regards the simplification of the implementation of harmonised rules on artificial intelligence (Official Journal, 24 July 2026); in force on the third day after publication (its Article 4), 27 July 2026. Its Article 1 amends Regulation (EU) 2024/1689 | The legal note: the amending Regulation, in force from 27 July 2026 |
EU AI Act — Commission guidelines (non-binding) | Draft Commission guidelines on the classification of high-risk AI systems, published 19 May 2026 for targeted consultation (general principles; Annex I; Annex III); a draft on 8 October 2026, not adopted | Stage 3: the draft guidelines on classification. They are a draft, so Legal confirms each reading |
NIST AI RMF 1.0 | GOVERN 1.3 — “Processes, procedures, and practices are in place to determine the needed level of risk management activities based on the organization’s risk tolerance.” | Stages 2 and 4: the level of risk management follows the organisation's risk tolerance |
NIST AI RMF 1.0 | MAP 3.5 — “Processes for human oversight are defined, assessed, and documented in accordance with organizational policies from the GOVERN function.” | Stage 4 and conditions: human oversight defined for each use |
NIST AI RMF 1.0 | MANAGE 1.1 — “A determination is made as to whether the AI system achieves its intended purposes and stated objectives and whether its development or deployment should proceed.” | Stage 4: a decision whether the use should proceed |
GDPR — Regulation (EU) 2016/679 | Article 22(1) — “The data subject shall have the right not to be subject to a decision based solely on automated processing, including profiling, which produces legal effects concerning him or her or similarly significantly affects him or her.” Article 22(3) requires, for the cases in Article 22(2), points (a) and (c), at least the right to obtain human intervention, to express a point of view and to contest the decision | Stage 2: a use that decides or shapes a decision about a person is Tier 3 |
GDPR — Regulation (EU) 2016/679 | Article 28(3) — a binding contract with the processor, covering documented instructions, confidentiality, security, sub-processors, assistance, return or deletion of data, and audits | Hold H-3 and ST-2: processor terms |
GDPR — Regulation (EU) 2016/679 | Article 35(1) — where a type of processing, in particular using new technologies, is likely to result in a high risk to the rights and freedoms of natural persons, the controller carries out “prior to the processing” an assessment of the impact on the protection of personal data; a single assessment may address a set of similar processing operations with similar high risks | Stage 3: the data protection impact assessment |
GDPR — Regulation (EU) 2016/679 | Article 35(3) — a data protection impact assessment is required in particular for a systematic and extensive evaluation of personal aspects of natural persons based on automated processing, including profiling, on which decisions with legal or similarly significant effects are based; for processing on a large scale of special categories of data; and for systematic monitoring of a publicly accessible area on a large scale | Stage 3: the cases where an assessment is required |
NIS2 — Directive (EU) 2022/2555 | Article 21(2)(d) — “supply chain security, including security-related aspects concerning the relationships between each entity and its direct suppliers or service providers” | Stage 3 and supplier terms: supply chain security |
ISO/IEC 27001 and ISO/IEC 42001 references name the clause or control this document relates to, by number and title only. ISO/IEC 42001 is a paid standard whose text was not read for this document. A reference does not say that meeting a clause or control meets any requirement of the EU AI Act.
Definitions
Term | Meaning in this procedure |
|---|---|
AI use | One way the organisation uses an AI system, for one purpose, with one owner: summarising meeting notes with the office assistant, or forecasting stock with the warehouse system. One tool can have several uses. The inventory lists uses. |
Approved tool | An AI tool on the approved list (A07) with a state of Approved or Approved with conditions, and the data levels it may take. |
Tier | How much checking a proposed use needs before it starts: Tier 1 a screen, Tier 2 an assessment, Tier 3 an assessment and an executive decision. A fourth outcome, Stop, means the use is not allowed. |
Unapproved use | Any use of an AI tool for work that is not on the approved list, or with data above what the list allows. Sometimes called shadow AI. |