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.