Highway Asset Form 3

SURPLUS OR TRANSFER OF AN ASSET FORM

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) RIDGID INDUCTIVE CLAMP 6677 Recycle Cardiac Science AED 4435 Recycle Cardiac Science AED 6102 Recycle Cardiac Science AED 6103 Recycle

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.

Send completed form to the Finance Director.

cc: Paula Freedman Paul Adams