Surplus Transfer of Equipment Form

Department Transferring Equipment Department Receiving Equipment
*Dep Rep:  Signature: Dep Rep:  Signature:
*People Soft ID No: Dep. Name/People Soft ID. No:
*Phone No: Phone No:
*Date:  Date: 
*Email:
UTHSC-H Tag No Asset Description
Make / Model No.
Serial No.
(Please include for controlled assets)
EH&S
Initial & Date
Working Room No. Building
Y:N:
Y:N:
Y:N:
Y:N:
Y:N:
Y:N:
Y:N:
Y:N:
Y:N:
Y:N:
Y:N:
Y:N:
Comments:



This form is required when assets are transferred to surplus for redistribution or sale through UT- Houston's public auction. Please do not store equipment awaiting surplus transfer in hallways or egress corridors. Please fill out this form completely, and submit to Environmental Health & Safety.