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INDIAN RIVER COUNTY <br />FORM FOR DISPOSAL/TRANSFER OF EXCESS PROPERTY <br />TO: Raeanne Cone, Finance Department `r <br />DATE: Declared Surplt5i 1/15 Hot � 8 IBIS <br />SUBJECT: Disposal/Transfer of Excess Property _-- <br />FROM: <br />Check One: Surplus Transfer X Trade -In Non -Capital Missing/Stolen <br />Asset Number 23530 Department: Bu, ta.+-jf� Fleet Number: 814 <br />Sena] Number- I FTRF12 W76KD98933 <br />Description 2006 FORD F-150 <br />Do you have possession of the asset? Yes No <br />If Lost/Missing has a police report been filed? Yes No <br />If yes, please attach a copy of the police report. If no, state reason: <br />Is the item functional/IVORR7NG CONDITION and could be used by another department? Yes l�) No <br />If not in working condition, description of problems with item <br />If transfer, department transferred to: <br />Contact Person: A V t -J Telephone Number - <br />Physical Location of asset: r -J -e -M - <br />(The above information will aid Purchasing and Facilities Management in the process of equipment removal from department). <br />If asset will be replaced, please answer the following. <br />Purchase Orddeerj Number for Replacement. Date Replacement Received <br />Approval L J1 ! 'I 1 oq,, L, <br />Captial Asset Custodian Date <br />Approval <br />Supervisor/Manager <br />Approval <br />Director <br />If asset transfer, approval of denartrnent receivingassel <br />Approval <br />Director <br />Additional Comments: <br />To be completed by Budget Department. <br />Date <br />Date <br />11/ 9 /-o <br />Date <br />Approved for- Surplus Transf. Trade -In Replacement <br />Budget <br />Director Date <br />IT 1S THE DISPOSING DEPARTMENT'S RESPONSIBILITY TO KEEP THE ITEM UNTIL FACILITIES MANAGEMENT CAN PICK UP. <br />DO NOT REMOVE PROPERTY FROM YOUR LOCATION WITHOUT PROPER AUTHORIZATION FOR DISPOSAL. <br />This form is to be used for all property with or without an asset number assigned. <br />Please attach a copy of this fonn securely to the item being disposed of <br />All other forms for disposal/transfer of property now obsolete. <br />Revised: August 2015 <br />P19 <br />