AM Surplus Request
Request ID:

Request Date:
//
Request Status:
Submitted
Department:
 Statistics
Pick Up Location:
SAS Hall 
Surplus Action:
Pick-Up
Comments: Room Should be unlocked
#






QTY






Lot
N
N
N
N
N

Description
Xerox Laser Printer
Dell Laptop 
Compaq Server Rack
Book Shelf w/ Shelves
Whiteboard 'x'

Data Security Warning

Created By:
Last Updated:

Y

TBYRON
TBYRON

Contact:
Phone:
Fax:
Email:

Serial #
XL
GZXYN

I have read and understand the Data Security Warning

// AM
// AM

End of Report

Terry Byron
/-
/-
tbyron@ncsuedu

Project






Asset Tag #

Certified by:

TBYRON

Asset ID

Condition
Poor
Poor
Good
Good
Good