SURPLUS OR TRANSFER OF AN ASSET FORM
To
Supervisor and Town Board
Department Head
Are ke
Prepared By
“JViantnsne Zamt~
Date
a). /2ce. 5
I request permission to surplus the following assets which are no longer of any use to my department.
Proposed disposition (recycle, transfer, auction) of the assets are listed.
ITEM ASSET TAG # DISPOSITION (recycle, transfer, auction) 2013 Ford Ya — <. ' " e280 _ # 5190 Stra ~ docalenk
Department Head Signature
lt J LL’ [/
Date of Town Board Approval:
Once approved by the Town Board, please complete a Deletion/Transfer Form. For Vehicles and Equipment complete a Vehicle/Motorized Equipment Form.
7
Send completed form to the Finance Director.
ec: Paula Freedman Kathy Tanea
End of document