802.4E3 - Fixed Assets Management System Fixed Assets Relocation/Transfer Form

Transfer Date:                                       Bar Code Number: ____________________________________

Description:    ________________________________________________________________________   ____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________

Quantity:    __________________      Serial/Model Number: ___________________________________

Transfer From:

Building: _____________________________________________________________________________ 

Building Code: __________________________  Department/Room:_____________________________

Controlling Person:                                                                 Completed by:                                                
                                                                                                                     (Initials)               (date)

Transfer To:

Building: _____________________________________________________________________________  

Building Code: __________________________  Department/Room: _____________________________

Reason for the Transfer: _________________________________________________________________
____________________________________________________________________________________

Controlling Person:                                                                 Completed by:                                                
                                                                                                                     (Initials)               (date)

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Authorization:

Entered into the Fixed Assets Management System Record by: __________________________________                                                                               
                                                                                                       (Initials)                                (date)

The upper portion of this form is to be completed in accordance with the Fixed Assets Management System Administrative Regulations.  The lower portion of this form is to be completed by the superintendent

Instructions:  This form is used only when a fixed assets is relocated/ transferred to another location for continued use.  The upper portion of this form is to be completed in accordance with the Fixed Assets Management System Administrative Regulations.  The lower portion of this form is to be completed by the superintendent.  The information on this form should be entered into the fixed assets management system on the same day the relocation/transfer is completed and no later than in the month in which the relocation/transfer occurred.