Work Order Number:
Office of Technology - Technology Equipment Surplus Form
1. Create a work order through Technology Support Center at 543-4357 to have the equipment picked up.
2. Complete form listing only the major equipment and accompanying peripherals. Ex.: 3 Monitors, 5 keyboards,
speakers and, mouse.
OFFICE OF TECHNOLOGY:
Receiver's Signature: Date:
3. Photocopy the form for your records. Present the signed form to the technician upon pick up of the equipment.
4. Please note that all items will be returned to Ward Edwards 0310 for processing.
Asset Tag # Serial Number Description of Equipment
Form Date: 1/6/2012 version 2.0