SOLD
On-Site
P.D Warehouse
The University of Michigan Office of Property Disposition
Declaration of Surplus Form
Phone:(734)764-2470 Fax:(734)763-2006
Declaration of Surplus #
Shortcode (Required)
Date:
1. Requirements
A. Please call Property Disposition at (734) 764-2470 to set up the time/date for delivering your items out to the warehouse. B. This form must be typed to insure legibility. C. You must provide your department Shortcode*** D. When sending computers, see #4 below.
2. Contact Information:
Contact Person:
3. Chartcom Information:
*** Shortcode:
Program:
Department Name:
Fund:
Class:
Address:
Dept ID:
Project Grant:
Phone:
Dept Fax:
4. For Computers Only:
If computers or storage media are being declared as surplus, the following statement must be clearly signed in accordance with SPG 520.1 I certify that all surplus computers and storage media declared on this form have been sanitized (all applications and data removed) in accordance with SPG 520.1 Yrs./ Estimated For Computers Only Condition Age Months Original Cost Value RAM Hard Drive Speed
(Please Print Name)
Specific Description 1 2 3 4 5 6 7 8 9
57e89df0-a308-43a7-8ebe-10058782518c.xls
(Signature)
Qty Category Description U of M Tag # Serial #
Page 1 of 3
2/26/2009
Specific Description 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Qty
Category Description
U of M Tag #
Serial #
Condition
Yrs./ Age Months
Original Cost
Estimated Value
For Computers Only RAM Hard Drive Speed
57e89df0-a308-43a7-8ebe-10058782518c.xls
Page 2 of 3
2/26/2009
Specific Description 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48
Qty
Category Description
U of M Tag #
Serial #
Condition
Yrs./ Age Months
Original Cost
Estimated Value
For Computers Only RAM Hard Drive Speed
57e89df0-a308-43a7-8ebe-10058782518c.xls
Page 3 of 3
2/26/2009