Fillable See attached instructions for completing form. Action (Indicate (New Jersey Institute of Technology)

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See attached instructions for completing form.
Email Address:
Department: Fax number:
Action
Code **
NJIT Bar Code
Tag **
Purchase Order
No.
From
(Indicate Building,
Floor and Room) ***
New Property Custodian
Name, Address, and Extension ***
If more than four (4) adjustments, continue on supplemental sheet.
** Required information.
***Required information for action codes 1A, 1B, 1C, 2, 3, 9, 10, 11.
Model Number
Serial Number
Acquisition Date Net Book Value
Date
Signature/Date
New Jersey Institute of Technology
Equipment Status Adjustment Form
Property Custodian:
Telephone Number:
Asset Description **
To
(Indicate Building,
Floor and Room) ***
Description
Property Control Update
Print Name
Source of Funding (and
title)
Property Custodian
Extension
Performed by
Date
For equipment transferred to NJIT, complete the following:
Signature/Date
Department Head/Chair
Research Office
Print Name
Signature
Make
Original Acquisition Cost
Email Address:
Department: Fax number:
Action
Code **
NJIT Bar Code
Tag **
Purchase Order
No.
From
(Indicate Building,
Floor and Room) ***
New Property Custodian
Name, Address, and Extension ***
** Required information.
***Required information for action codes 1A, 1B, 1C, 2, 3, 9, 10, 11.
New Jersey Institute of Technology
Equipment Status Adjustment Form
Property Custodian:
Supplemental Sheet
Transfer/Loan
Asset Description **
To
(Indicate Building,
Floor and Room) ***
Telephone Number:
General Information:
Department Head/Chair signature is required for all status adjustments.
Action Codes: Select one of the following codes that best describes the equipment status change:
Code
1A
1B
1C
2
3
4
5
6
7
8
9
10
11
propertycontrol@njit.edu
Equipment on loan to another institution. The University retains title and is accountable for the property.
New Jersey Institute of Technology
Equipment Status Adjustment Form
Instructions
This form is to be used in conjunction with the University Policies and Procedures document PP 13-06 Capital Assets - Accounting and
Control located at: http://www.njit.edu/policies.
The Property Custodian is responsible for completing this form and obtaining appropriate signatures.
Research Office approval is required for assets acquired under sponsored agreements or on loan in connection with a sponsored agreement.
Description
Government equipment transferred to NJIT. Title passes to NJIT.
Government equipment transferred to NJIT. Title remains with Government.
Nongovernment equipment transferred to NJIT. Title passes to NJIT.
Equipment transferred from NJIT to another institution. The University no longer has title to or is accountable for the property.
Questions regarding the Equipment Status Adjustment Form should be directed to Property Control at extension 7737.
Surplus
Sold. Attach copy of cash receipt.
Trade-in on new equipment. List PO number(s) for new equipment:________________________________________________
Stolen. Attach copy of security report.
Obsolete/Impaired
Off campus transfer to faculty, staff, or student. University retains title and is accountable for the property. Must include name,
address, and phone number of new property custodian.
Equipment on loan to the University
Other (e.g., permanent change of on-campus location, change in property custodian). Explain in space provided below.
The completed and signed Equipment Status Adjustment Form, along with supporting documentation, should be scanned and sent to:
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Completed 24 August 2020

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