A one-page instrument for rapid AI exposure visibility before approval or scale.
Purpose & Audience
Provides leaders accountable for AI approval and oversight — Board, CEO, CFO, CIO/CTO, Risk/Compliance, and General Counsel — a structural view of material AI exposure.
This instrument surfaces risk signals. It does not score readiness.
This is not a technical implementation guide. It is a governance visibility tool
SECTION 1 — AI Use Case Identification
AI System / Initiative Name: ___________
Business Objective (JTBD): ___________
Primary Workflow Impacted: ___________
Decision Influence Level: ☐ Advisory ☐ Assisted ☐ Autonomous
SECTION 2 — Materiality Classification
Business Impact: ☐ Low ☐ Moderate ☐ Material
Regulatory / Legal Exposure: ☐ None ☐ Moderate ☐ High
Scale Exposure: ☐ Pilot ☐ Departmental ☐ Enterprise
Board Visibility Threshold Triggered? ☐ Yes ☐ No ☐ Unclear
SECTION 3 — Named Accountability
Named Executive Owner: ___________
Stop Authority Defined? ☐ Yes ☐ No
Escalation Path Documented? ☐ Yes ☐ No
Cross-Functional Review Completed? ☐ Technology ☐ Risk / Compliance ☐ Legal ☐ Finance ☐ None
If any discipline is absent, oversight compression risk exists.
SECTION 4 — Structural Exposure Signals
☐ Authority boundaries unclear
☐ Decision accountability diffused
☐ Monitoring responsibility ambiguous
☐ Workflow boundaries altered without governance revalidation
☐ Vendor claims unverified
☐ Evidence chain incomplete
☐ AI connected to downstream tools without centralized reviewUnchecked does not imply safety. Unknown implies exposure.
If defensibility cannot be demonstrated at decision-time, approval risk is high.
SECTION 5 — Decision-Time Defensibility Check
Can this decision path be reconstructed today?
☐ Yes ☐ Partial ☐ No
Is monitoring evidence archived? ☐ Yes ☐ Partial ☐ No
Would this withstand regulatory inquiry? ☐ Yes ☐ Uncertain ☐ No
If defensibility cannot be demonstrated at decision-time, approval risk is elevated.
SECTION 6 — Executive Signal
Preliminary Exposure Assessment this signal is diagnostic, not approval authority.
☐ Structurally Stable ☐ Operationally Exposed ☐ Governance Immature ☐ Approval Risk High
Closing Statement
AI scales what already exists.
If accountability is unclear, it scales diffusion. If oversight is thin, it scales liability.
If this snapshot reveals structural exposure, a structured Executive Governance Review provides deeper accountability mapping and oversight architecture alignment.