[FrontPage Save Results Component]

                              uchc_logo.gif (10775 bytes)REFERENCE # F Hit Counter            
                                                                                                          INVENTORY CONTROL
                                                                                 "PROPERTY DISPOSITION FORM" - IC-6

MAIL ENTIRE PACKAGE TO:      Inventory Control,  Building J,   MC 6170                                                Phone:   679-1952  
NAME:    
BUILDING: FLOOR: ROOM  #:      TEL. #:      
DEPARTMENT:
MAIL CODE:  MC         E-MAIL: 
RECOMMENDED DISPOSITION:                        To Declare Property Excess/Surplus:   dotblink.gif (1956 bytes)
1.
      Transfer to Another
      Institution 		2.  
      Trade In		 3.  
      Sell (Bid Process)		 4.  
      Cannibalize		 5.  
      Other: 
EXPLANATION OF RECOMMENDED DISPOSITION:

HC #

DESCRIPTION

 LOCATION

PO NUMBER

FUND

GRANT #

 COST

REMARKS: 

 

 

CODING:

FISCAL YR

LEDGER

ACCOUNT

SUBCODE

AMOUNT

AUTHORIZED SIGNATURE
 

________________________

IMPORTANT NOTICES TO DEPARTMENT HEAD:

  1. YOUR SIGNATURE ALSO CONFIRMS THAT ALL EQUIPMENT & ACCESSORIES USED WITH/OR HAVING CONTAINED RADIOACTIVE OR OTHER HAZARDOUS MATERIALS HAVE BEEN INSPECTED & APPROVED FOR SHIPPING AND/OR STORAGE BY ENVIRONMENTAL & RADIATION SAFETY.
     

  2. YOUR SIGNATURE ALSO CONFIRMS THAT ALL ELECTRONIC STORAGE EQUIPMENT & DEVICES HAVE BEEN PROPERLY CLEANED OF INFORMATION ACCORDING TO UCHC HIPAA POLICIES.

AUTHORIZED SIGNATURES    (Signatures Must Be In Order Stated)
___________________________
1.  DEPARTMENTAL PROPERTY COORDINATOR		 _______
DATE		 ____________________________
6. DEAN
   (Individual Equipment Over $10,000 Only)		 _______
DATE
___________________________
2.  PRINCIPAL INVESTIGATOR
    (Equipment Purchased on Research Grants Only)		 _______
DATE		 ___________________________
7.  INVENTORY CONTROL		 _______
DATE
___________________________
3. DEPARTMENT HEAD		 _______
DATE		 ____________________________
8. GRANTS ADMINISTRATION
    (Equipment Purchased on Research Grants Only)		 _______
DATE
___________________________
4. VICE PRESIDENT FOR RESEARCH
   (Individual Equipment Over $10,000 Only)		 _______
DATE		 ___________________________________
9. UNIVERSITY DIRECTOR OF MATERIALS MANAGEMENT
   (All Asset Transactions)		 _______
DATE
____________________________
5. CONTROLLER
     (Equipment Leases Only)		 _______
DATE		 _____________________________
10. DIRECTOR OF  PURCHASING
       (Trade-In/Bid Only)		 _______
DATE

OPMM USE ONLY
RECEIVED BY:     
INITIALS: ________ 
TIME: ________  
DATE:  __________		 REQUEST IS: 
APPROVED:   
DENIED:       		SCHEDULED REMOVAL DATE: 

____________		 COMPLETED BY:   
INITIALS: ________ 
TIME: ________    
DATE:  __________

MAKE A COPY FOR YOUR FILE

IF YOU NEED ASSISTANCE COMPLETING THIS FORM, CALL 679-1952