FIXED ASSET RELOCATION FORM

WHEN FIXED ASSETS ASSIGNED TO YOU ARE RELOCATED, IT IS REQUIRED THAT YOU NOTIFY THE INTERNAL ACCOUNTANT OF THEIR NEW LOCATION. COMPLETE THE FORM BELOW AND RETURN TO THE INTERNAL ACCOUNTANT AS SOON AS POSSIBLE.

USUALLY, AN ASSET’S LOCATION IS DESIGNATED BY ASSIGNING IT TO THE INDIVIDUAL USING THE ASSET. THE INDIVIDUAL’S LAST NAME IS USED FOR THIS PURPOSE. IF RELOCATING AN ASSET TO OR FROM STORGE, USE “STORAGE” AS THE OLD OR NEW LOCATION.

FIXED ASSET

TAG NUMBER	OLD LOCATION

(YOUR LAST NAME)	NEW LOCATION

(YOUR LAST NAME)

SIGNATURE OF PERSON TRANSFERRING ASSET

DATE

DATE

DATE

SIGNATURE OF PERSON RECEIVING ASSET

DATE

DATE

DATE

NORTHWEST EDUCATIONAL SERVICE DISTRICT 189

FORM 6050-F2

Page 1 of 1

First Reading:

jmorrell

2004-08-09

Northwest ESD 189