WINTHROP UNIVERSITY
REQUEST FOR RELIEF OF ACCOUNTABLI
TY FOR PROPERTY
Date:
From: Dept. Name Dept. No.
SECTION 1: RELIEF OF ACCOUNTABLITY IS REQUESTED ON THE FOLLOWING EQUIPMENT
Location of Property ________________________________________ WU Decal No. _____________________________
Description Serial or Model No.
Date Acquired ___________________ Condition ______________________________ Cost ________________________
Source of Funds
(please circle) : State Federal Other
Please check reason for relief of accountability:
______
______
______
1. Lost or Stolen (If lost or stolen, complete Section Il.)
2. Replaced by purchase of new equipment (If traded, complete Section Ill.)
3. Transferred within the Department from Room No. to Room No. ________
4. Equipment removed from use / being held for parts to repair / rebuild other equipment
Dept. Accountable Officer
SECTION 2: TO BE COMPLETED ONLY ON
LOST OR STOLEN PROPERTY
1. Name of individual directly responsible for equipment lost or stolen
2. Date and Time of Loss ______________________________________________________________________
3. Circumstances regarding loss
4. Has Provost and Security been notified? Date
5. What steps have been taken to prevent further losses?
6. Other remarks: (Use reverse side)
Dept. Accountable Officer
SECTION 3: TO BE COMPIETED ONLY
WHEN PROPERTY IS TRADED
l. Name of Vendor to whom property is to be traded
2. Trade in Allowance
3. Reason for Trading
Dept. Accountable Officer
Property Control Form No. I-I Revised 5-2017
