The AI System Impact Assessment Worksheet
Template
A worksheet for assessing how an AI system could affect people and society, structured so it can be revisited as the system changes.
System and context
- Summarise purpose, users, data, level of autonomy and deployment context.
- Describe foreseeable misuse and use outside the intended context.
Affected parties
- List people affected directly and indirectly, including people who never use the system.
- Identify groups who could be affected differently from others.
Benefits and harms
- Record expected benefits and who receives them.
- Record potential harms, their likelihood, severity and reversibility.
- Note where this assessment overlaps a DPIA or fundamental rights impact assessment.
Triggers and owners
- Link each significant impact to a control and an owner in the risk register.
- Name the events that require reassessment: new model, new user group, new market, significant incident.
- Set the next scheduled review date.
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