# Free sample — Change Order (one page)

**From Marvin kits** · Not legal advice · Personal use in your own freelancing practice

*One form per change. Attach to your original SOW / quote.*

**Change Order #:** ____  
**Project:** ____________  
**Date requested:** ____________  
**Requested by:** ____________  

## Description of change

What is being added, removed, or altered?



## Impact

| Impact | Detail |
| --- | --- |
| Extra fee (USD) | $ |
| Timeline change | + ____ business days (new delivery: ____) |
| Deliverables added | |
| Deliverables removed / deferred | |
| Revision rounds reset? | Yes / No |

## Approval

Work on this change **starts only after** both parties confirm in writing.

Client approval (name / date / “Approved”): ________________  

Provider acknowledgment: ________________  

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### Copy-paste reply (Slack / email)

> Happy to. That sits outside our current scope — I’ll send fee and timing and start when you confirm.

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