RICHARD STOCKTON COLLEGE
EQUIPMENT REPAIR NOTIFICATION FORM
TAG NO.EQUIPMENT LOCATION
DEPT.
EQUIPMENT DESCRIPTION (INCLUDE SERIAL NO.)
NAME OF VENDOR MAKING REPAIRS:
NAME OF VENDOR FROM WHOM PURCHASED IF DIFFERENT FROM ABOVE:
APO NO. COVERING PURCHASE
DAMAGED IN TRANSIT
WARRANTY REPAIR
APO NO. COVERING REPAIR
CHARGE REPAIR
20
DATE FORWARDED TO VENDOR
NAME OF TRUCKER OR OTHER METHOD OF SHIPMENT:
DECLARED INSURANCE VALUE:
$
20
VENDOR'S PROMISED RETURN DATE:
INSTRUCTIONS TO CENTRAL STORES
DATE
AUTHORIZED SIGNATURE
(College Employee)
DATE
SIGNATURE
(Vendor Rep. - Where Applicable)
NOTE:
This form is to be completed
and promptly forwarded to
Central Stores whenever
equipment goes off Campus
for repairs or servicing
ssc6021/99
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