Report of Survey/Inventory Adjustment Report
Address:
Central Carolina Technical College
506 N. Guignard Dr.
Sumter, SC 29150
Page:_______of______
Date:_______________
Report Number:_______________
Section I.
_____ A. Traded
_____ H. Transfer to another State Agency
_____ F. Return to Vendor
_____ B. Sold
_____ I. Trashed/Disposed
_____ N. Cannibilized
_____ C. Stolen
_____ Y. Operational Loss
_____ Z. Drop from records
The following equipment is:
Section II.
State ID Number
Description of Equipment
Serial Number Date Purchased
Fund Code
Cost
Use Additional Attachments If Necessary.
Total: ___________
Section III.
Enter a complete statement of facts concerning this matter:
__________________________________
Signature of Department Head
__________________________
Department
_____________________
Date of Incident
The College will report all missing equipment as stolen and attach a copy of the Police Report. The College
will give a statement of conditions leading to this report and corrective actions taken:
__________________________________
Signature of Equipment Coordinator
_____________________
Date
I have reviewed the items in this report and I am satised that the statements are true and complete:
__________________________________
Signature of Equipment Manager
_____________________
Action/Completion Date
__________________________________
Signature of President or Vice President
_____________________
Date
CCTC Inventory Control Form No.1 (Rev. 7/2017)
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