EQUIPMENT LOCATION CHANGE/TRANSFER FORM Instructions: This form should be used to report the following: Location changes (please complete section A & C); Transfer to another Department (please complete section B & C). After the proper signatures have been obtained, please forward the original to the Controller’s office for approval. When approved, a copy of the request will be returned to the department(s) involved. (Stolen Equipment: do not use this form – Report to Public Safety and forward information to Controller’s Office). SECTION A – Location Change Current Location New Location CSM Tag Number Item Description Building Room Building Room Responsible Department: Request relocation for the above listed items. Dept. Name: Dept. Head Name: Dept. Head Signature: Date: SECTION B – Transfer to Another Department NEW Location Remarks/Reason CSM Tag Number Item Description Building Room for Change Releasing Department: Acquiring Department: Request release of accountability for the above listed items. This department accepts accountability for the above listed items. Dept. Name: Dept. Name: Dept. Head Name: Dept. Head Name: Dept. Head Signature: Dept. Head Signature: Date: Date:
EQUIPMENT LOCATION CHANGE/TRANSFER FORM Instructions: This form should be used to report the following: Location changes (please complete section A & C); Transfer to another Department (please complete section B & C). After the proper signatures have been obtained, please forward the original to the Controller’s office for approval. When approved, a copy of the request will be returned to the department(s) involved. (Stolen Equipment: do not use this form – Report to Public Safety and forward information to Controller’s Office). SECTION A – Location Change CSM Tag Number Item Description Current Location Building Room New Location Building Room Responsible Department: Request relocation for the above listed items. Dept. Name: Dept. Head Name: Dept. Head Signature: Date: SECTION B – Transfer to Another Department CSM Tag Number Item Description NEW Location Building Room Remarks/Reason for Change Releasing Department: Acquiring Department: Request release of accountability for the above listed items. This department accepts accountability for the above listed items. Dept. Name: Dept. Name: Dept. Head Name: Dept. Head Name: Dept. Head Signature: Dept. Head Signature: Date: Date:
EQUIPMENT%20LOCATION%20CHANGE-TRANSFER%20FORM.docx