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Equipment Accountability Change Request

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					                                                            COLORADO STATE UNIVERSITY
                                                         EQUIPMENT ACCOUNTABILITY CHANGE REQUEST
RETURN TO: Property Management Office                       See detailed instructions on back of this form                                       LOT #
   122 Johnson Hall - x12270, fax x12380
TYPE OF DISPOSITION                                         PURCHASING USE ONLY                                   PROPERTY MANAGEMENT USE ONLY
 CANNIBALIZATION (prior approval)                           Okay for Pick Up _________________ date             Date Recorded __________________
 LOCATION/RESPONSIBILITY CHANGE                             Picked Up/Delivered ________________ date
x SURPLUS EQUIPMENT                                          Other _________________________
 TRADE-IN (Req#                 )                                                                                Property Signature
 OTHER

     Property Management Office Signature                          Purchasing Approval                            Authorized Signature
      *Reason for disposal: 1-Obsolete 2-Beyond Repair      3-Excess      **Equipment Condition Code 1-Operational 2-Needs Repair 3-Beyond Repair
Serial              CSU Decal          Item                                      Manufacturer      Model          Location Location Reason Cond Funding             Value
Number              Number             Description                                                                Building Room # Code* Code**
None               None                 Rolodex                                                                     1125        7            1       1
                                        Toner                                   Canon            NPG-7              1125        7            1       1
                                        Videocassette                           Scotch           TC-30              1125        7            1       1
                                        Videocassette                           TDK              MA90               1125        7            1       1
                                        3 1/2" Floopy Disk Holders (2)                                              1125        7            1       1
                                        3 1/2" Floopy Disks (Two Boxes)                                             1125        7            1       1
                                        VHS Videocassette Cases (4)                                                 1125        7            1       1
                                        Power Adapter                           TI                                  1125        7            3       1
                                        Avery Phone Message Book                                                    1125        7            3       1




Releasing Department Authorization (Please don't use black ink.)                                 Acquiring Department Acceptance (Please don't use black ink.)

                 CIRA
Dept Name ___________________________________                            1375
                                                            Dept # _________                     Dept Name _______________________________               Dept # _________


Authorized Signature                                               Date                          Authorized Signature                                    Date
Telephone Extension ______________________                                                       Telephone Extension ______________________                         Rev. 03/16/99


CIRA
Internal           Infrastructure Manager - Mike Hiatt                                                            Surplus form Prepared by
Signatures
                   Checked Against CIRA Inventory List By Marilyn Watson
                                                                    COLORADO STATE UNIVERSITY
                                                              EQUIPMENT ACCOUNTABILITY CHANGE REQUEST
                                                                              (EACR)
INSTRUCTIONS FOR COMPLETING THIS FORM
GENERAL INFORMATION - For more detailed instruction consult Financial Policy and Procedure Instructions, FPI 25.10
Use this form for the following situations:
1     MOVEMENT of equipment within your department including CHECK-OUT                                          5* TRANSFER of equipment to another institution or agency
2     TRANSFER of equipment to another CSU department                                                           6* SURPLUS of equipment to be auctioned
3*    DISPOSAL of equipment or other CSU owned goods for any reason                                             7* CANNIBALIZATION of equipment
4*    SALE of equipment within or outside the University                                                        8* DONATION of equipment to other institutions or agencies
9*    TRADE-IN of EQUIPMENT must be done through Purchasing. The original EACR with property approvals must accompany the purchase requisition to the purchasing office.
      A description of the equipment traded including the CSU property tag number should be included on the purchase requisition.
*All of the starred situations need prior approval of both the Purchasing Department and the Property Management Office.
      If there are more items than will fit on one page, please fill out an additional form and have each form authorized.

     SHADED AREAS ARE FOR PURCHASING AND PROPERTY INFO ONLY - Departments do not need to fill in anything in these areas.

     Do not use this form for the following:
     1   FEDERAL, SPONSOR OR LEASED equipment cannot be disposed without release of ownership to CSU title. Contact Property Management for information and special processing. x12270.
     2   STOLEN EQUIPMENT is to be reported to CSU Police. (No need to fill out this form.)

COMPLETING THE FIRST SECTION - TYPE OF DISPOSITION
     CANNIBALIZATION - Check this if you plan to use parts of a piece of equipment within your department. (REQUIRES PRIOR APPROVAL) Surplus will pick up what is left.

     LOCATION/RESPONSIBILITY CHANGE-Check this if you are moving within your department or transferring between departments or using as CHECK-OUT form indicate the NEW location of the
        equipment. (NO PRIOR APPROVAL)

     SURPLUS EQUIPMENT - Check this box if you don't need or want the equipment and would like the Surplus Warehouse to schedule pickup of the items.

     OTHER - Use for other types of disposition such as:
                   Sale of Equipment inside or outside CSU (REQUIRES PRIOR APPROVAL)
                   Transfer of Equipment to another institution or agency (REQUIRES PRIOR APPROVAL)
                   Donation of Equipment to other institutions or firms (REQUIRES PRIOR APPROVAL)

     PRELIMINARY APPROVAL - CSU Property Management signs this box upon approval of disposition.

COMPLETING THE SECOND SECTION - EQUIPMENT/GOODS INFORMATION
     All the information pertinent to the item being disposed is necessary in this section. (Shaded areas are not.) It is important that Property Management can identify the items being
     disposed. If the CSU tag is missing or written in error the other demographic information can help identify the item.

     *Reason Code - Three codes are listed in the space above the box. 1-Obsolete, 2-Beyond Repair, 3-Excess

     **Condition Code - Three codes are listed in the space above the box. 1-Operational, 2-Needs Repair, 3-Beyond Repair

COMPLETING THE RELEASING DEPARTMENT AUTHORIZATION BOX
     The Department that owns the equipment listed in the second section should have their authorized persons sign this signature box. Property Management has the list of these
     signers if you are unsure. x12270.

COMPLETING THE ACQUIRING DEPARTMENT AUTHORIZATION BOX
     The Department to whom the equipment listed in the second section is being transferred should have their authorized persons sign this signature box. Property Management has the list
     of these signers if you are unsure. x12270.

				
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