Surplus Property Pick-Up Request Form

If you see this don't fill out this input box.

I have transferred the following items listed and described below, through the online inventory system and request that the items be picked up by Texas Tech Surplus.

Requestor Information

*Requestor's First Name:

*Requestor's Last Name:

*Email:

*Department:

*Organization Code:

*Date:

Item Information

*1. Transfer #:

*Asset Tag #:

*Description:

*Serial #:

*Building Name:

*Room #:

2. Transfer #:

Asset Tag #:

Description:

Serial #:

Building Name:

Room #:

3. Transfer #:

Asset Tag #:

Description:

Serial #:

Building Name:

Room #:

4. Transfer #:

Asset Tag #:

Description:

Serial #:

Building Name:

Room #:

5. Transfer #

Asset Tag #

Description:

Serial #:

Building Name:

Room #:

6. Transfer #

Asset Tag #:

Description:

Serial #:

Building Name:

Room #:

7.Transfer #:

Asset Tag #:

Description:

Serial #:

Building Name:

Room #

8. Transfer #:

Asset Tag #:

Description:

Serial #:

Building Name:

Room #:

9. Transfer #:

Asset Tag #:

Description:

Serial #:

Building Name:

Room #:

10. Transfer #:

Asset Tag #:

Description:

Serial #:

Building Name:

Room #:

Certification

If any of the above items are computers, please fill out the below certification.

I certify that the hard drive has been ERASED:

YES

I certify that the equipment has been checked for HAZARDOUS MATERIALS:

YES

Full Name:

Date:

Operations Division: Planning and Administration

Address

Mail Stop: 5091, Box: 45091, Physical Plant Building, 3122 Main Street, Lubbock, TX 79409
Phone
(806) 742- 4677
Email
operations@ttu.edu

Surplus Property Pick-Up Request Form

Address

Phone

Email