UW Tag # Manufacturer
Model Item Description (required)
Building
Name
Room # /
Location
Operational
(Y/N)
Requested
Disposal Price
Determined
Market Value
Item
Destination
Department Name:
Department Code:
Contact Person:
Contact Phone:
Are All Items Available for Pickup Immediately? Yes No
Date Available for Pickup:
Type of Disposition
S
urplus Property
T
ransfer of Property (Provide Department)
Ot
her (Provide Reason)
A
dditional Detail:
I authorize the items listed to be released to Surplus Property for sale, transfer, or disposal in accordance with
existing policies.
Authorized signature must be from a Dean, Director, or Department Head.
Print Name Authorized Signature Date
Asset Management / Surplus Property Use Only
Date Received: By:
Date Processed: By:
AM Updated: By:
Sponsored Programs Approval: By:
PDR to Material Services: By:
PDR to RMMC / Asset Mgt. By:
Notes:
Surplus Property
Property Disposal Request Form
Instructions: Please fill out each section of this form completely. If you have questions about this form or the process, contact Material Services at 307-766-2409.
The department certifies that all items listed below are clean of
chemical, biological and radioactive material.
S
urplus Property will sanitize h ard drives to NIST.SP.800-88r1
specifications or destroyed based on condition.
I unde
rstand that Surplus Property will review requested
disposal price. If requested disposal price is left blank, Surplus
Property will determine market value/selling price. If it is
determined it does not reflect the market they will work with
department to establish the basis for the sale price.
SECTION 4 Please enter as much information as possible about each item in the table below.
Grey areas are to be filled out by Surplus Property/Asset Management personnel only
Send This Form via UW Campus Mail, scanned into an email (property@uwyo.edu), or fax (307-766-6762) to UW
Asset Management Office for approval. Pickup will be scheduled only after PDR approval.
