MISSING EQUIPMENT CONTROL FORM
DEPARTMENT ______________________________
ETSU
# DESCRIPTION MODEL# SERIAL# COST ACQ DATE
PLEASE ANSWER THE FOLLOWING QUESTIONS IN DETAIL
1) What was the last known
location of the missing equipment? ________________________________________________________
2) When was the missing equipment last seen? ______________________________________________________________________
3) Was the missing equipment vital to the operation of your department? YES____ NO_____
4) When was the equipment last used? ____________________________________________________________________________
____________________________________________________________________________________________________________
5) If equipment was not in use and not vital to your department, please explain why it had not been declared surplus: ______________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
6) Please describe what steps have been taken to locate the missing equipment: ___________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
7) Will the missing equipment need to be replaced? YES____ (go to #8) NO____ (go to #9)
8) What index number will be used to pay for the replacement equipment? ___________________
9) Please describe steps that have been taken to prevent equipment loss from occurring in the future: _________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
PLEASE OBTAIN THE FOLLOWING SIGNATURES.
UPON COMPLETION, THE FORM CAN BE EMAILED TO
JAY SEEHORN, CENTRAL RECEIVING SUPERVISOR, AT SEEHORNJ@ETSU.EDU OR FAXED TO 439-5793.
________________________ _____________________________ ____________________________
DEPT. HEAD DATE DEAN/DIRECTOR DATE VICE-PRESIDENT DATE
