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California State University, Long BeachCalifornia State University, Long Beach

PROPERTY SURVEY / TRANSFER REQUEST FORM



INSTRUCTIONS:


  1. To request transfer or survey of University inventory property, departments are to complete and submit the Property Survey/Transfer Request Form to the PMO.
  2. Complete the form and use the button below to display a printer friendly version.
  3. Print the form and obtain the appropriate signatures. Approval of Appropriate Administrator (Level 4 - designated Division approver or back-up) is required. Appropriate Administrators may require additional department approval prior to division approval. The form includes a department record keeper signature line for department use only.
  4. Complete the media sanitization certification on the form for all media storage devices. Identify method of sanitization and applicable line items. Approval of Information Technology Coordinator is required.
  5. For Property Transfers to a campus department, the transfer to department is to certify that the property is approved for transfer by signing the Property Transfer Acceptance Approval (Transfer to Department) section. In addition, the new location where the property will be maintained is to be identified.
  6. Attach a copy of the form to the item.
  7. Return the form with the signatures to the Property Management Office or email the form to Property@csulb.edu
  8. The Property Management Office will contact the department regarding pick-up and/or drop-off requirements.
  9. For Property Transfers to another state agency, the other agency is to confirm receipt of the items by signing the Property Transfer Approval (Other Agency) section and forwarding the form to the Property Management Office.

Fields with * are required.

REQUESTOR INFORMATION

PROPERTY INFORMATION

Ln ITEM DESCRIPTION PropertyTag # Acquisition Year Original Value $ Est. Market Value $ Present Condition Code
Present Condition Code

A = Excellent & Good (working condition)

B = Fair (working condition, but needs repair)

C = Poor & Junk / Broken (not in working condition or obsolete)

Disposal Code
Disposal Code

1 = Remit to PMO for Disposal

2 = Transfer to CSULB Dept

3 = Transfer/Donation to Other Agency

4 = Trade In

5 = Lost / Missing

6 = Stolen

Transfer to Dept ID Transfer to Dept Name
1
2
3
4
5
6
PROPERTY TRANSFER ACCEPTANCE APPROVAL (Transfer to Department) (if applicable - Disposal code 2) I certify that the above listed property is approved for transfer to the identified Department and will be maintained at the location identified below.

PROPERTY TRANSFER APPROVAL (Other Agency) (if applicable - Disposal code 3) The item(s) above have been received.







TRADE-IN DETAILS (if applicable - Disposal code 4)
LOST/MISSING/STOLEN ITEM DETAILS (if applicable - Disposal code 5 and 6)




MEDIA SANITIZATION CERTIFICATION (if applicable) I certify that the electronic computing devices and/or electronic media itemized on this form have been properly cleared and/or destroyed according to the CSULB Electronic Media Sanitization Procedure.


PICKUP/DROP OFF

(lbs.)
(H * W * L in Feet)
DEPARTMENT APPROVAL I certify that to the best of my knowledge the above statements regarding University property are true and correct. The recommended disposition is in the best interest of the University.


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