Revised January 2013
Southwest Virginia Community College, PO Box SVCC, Richlands, VA 24641
Phone: 276/964-7339 - Fax: 276/596-9805
APPROVAL
Requester Date
VP of Academic & Student Services Date
Supervisor Date
VP of Financial, Admin, and Human Resources
Date
Dean Date
STOREKEEPER
Received by Storekeeper:
Date:
Signature
Moved to Surplus:
Date:
Signature
NOTES:
Once the form is completed, please forward to the Office of VP of Financial & Administrative Services for final
authorization/signature.
The VPFA Office will forward the form to the Physical Plant for processing. Prior to physical disposal, Physical Plant
personnel will complete a “Disposal Form” and route to the VPFA Office. Receipt of the document will initiate a disposal
status update in the College’s fixed asset inventory records/system.
SWCC Inventory Tag No.:
Item Description:
Caretaker’s Name:
Caretaker’s Department:
Telephone Extension:
INVENTORY SURPLUS FORM
REASON FOR REMOVAL
No longer current technology
Damaged/Broken - not worthy of repair
No longer has use in this area
Other:
The above-mentioned item is no longer of use at SWCC and deemed surplus property. The signatures below confirm the item is not usable in any
other area of the college. SWCC’s Physical Plant will warehouse the item until it is ready for disposal.