Assessment Asset Form

SURPLUS OR TRANSFER OF AN ASSET FORM

I request permission to surplus the following assets which are no longer of any use fo my department.

Proposed disposition (recycle, transfer, auction) of the assets are listed.

ITEM ASSET TAG #

DISPOSITION (recycle, transfer, auction)

LU Draw f sy Cabinet Blac} OO 1.03 ecu Ly

2" Butch - foe og, frin’s pest | _pOz0IY \

File Cobinet- Manso! ODD recycle,

MOdulay Desk Unt Mans poaabs recutle Diver leer fle mana NO3 809 "

5 Sawer _lakral Li Dom! 00270 : Department Head Signature: Opps. fv. ZA fer 5 [ [4 | Lb ;

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.

ce: Paula Freedman Kathy Tanea