Act-41 | Accounting Office | OFFICE OF THE ASSOCIATE VICE PRESIDENT OF FINANCIAL OPERATIONS AND CONTROLLER

ACT-41 Form

This field is for validation purposes and should be left unchanged.

Date(Required)

NetID(Required)

Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Department Name(Required)

The following equipment is being;(Required)

To the Depatment of:(Required)

Description(Required)

Serial Number(Required)

Model(Required)

Value(Required)

From: Building Name(Required)

From: Room Number(Required)

New location of equipment(Required)

From (Begining date)(Required)

Through (end date)(Required)

Will be used for (Purpose)(Required)

Attach any Supporting Documents

Max. file size: 250 MB.

Notes/Comments

Has Dean, Director, or Department Head approved?(Required)

Approved Dean, Director, or Dept Head email(Required)

Ready to submit?(Required)

Yes, ready to submit