Fillable CO Apdf (Southeast Missouri State University)

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CO Apdf (Southeast Missouri State University)

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Country of origin: US
File type: PDF

U.S.A. forms for Southeast Missouri State University

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Southeast Missouri State University
Request for Change in Accountability
This form must be completed in its entirety and returned to the Purchasing Department at MS3280 or emailed to
purchasing@semo.edu
. Failure to complete all sections may result in form being returned without being processed.
Please type or print clearly.
Disposition of item(s):
____________ Surplus to our needs.
____________ Being transferred (receiving and transferring department must complete below information).
____________ Stolen/lost. Copy of police report must be attached.
Transferring
Receiving
Department/Mail Stop:
____________________________
___________________________
Organization (Index):
____________________________
___________________________
Financial Manager Name:
____________________________
___________________________
Financial Manager Signature:
____________________________
___________________________
Financial Manager Financial Manager
The transferring department must complete the following questions for all of the items listed below. If the answer to any
of the questions is “yes”, please contact Purchasing for instructions.
Yes No Is any item known OR suspected to contain radioactive or hazardous material?
Yes No Was any item ever used or stored in a known OR suspected radioactively contaminated area?
Yes No Is any item capable of producing ionizing radiation? (Does not apply to televisions and computer monitors.)
Item information: Up to 5 items may be included on this form as long as disposition of all items is the same.
Inventory Tag
Number
Description
(Manufacturer/Model)
Serial
Number
Location
(Building/Room)
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Purchasing Updated by: _______________________________________________ Date: ____________________
Facilities Management Transferred by:_____________________________________________ Date: ____________________
Distribution: Purchasing - Original Transferring Department - Copy Receiving Department - Copy
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CO Apdf (Southeast Missouri State University)

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Completed 25 July 2020

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