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Departmental Equipment Change Report


Name or Description of Item
R.U. Property Tag number
Item Serial Number
Manufacturer

EQUIPMENT TRANSFER

Previous Location
Department
Building
 Room
Current Location
(Where equipment was transferred to)
Date of transfer
Department
Building
   

Other

(Select either trade-in, Scrapped, Stolen, Lost or Unable to locate item)
Trade-In List the P.O. Number
referencing trade-in
Scrapped  List applicable date
Stolen Date and Location item was last identified
  Date item was identified as stolen
Lost Date and locations item was last identified
  Date item was identified as lost
Unable to locate item
Comments
Prepared by Date

Please print before sumitting report.