Free SD Form 811, Request to Excess Information Technology Equipment, October 2001. - Federal

REQUEST TO EXCESS INFORMATION TECHNOLOGY EQUIPMENT
1. ORGANIZATION ACCOUNTABLE FOR EQUIPMENT 2. REPORT NUMBER JULIAN DATE DPI NO. (YDDD)

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3. JOB TICKET NUMBER

4. CONTACT FOR FURTHER INFORMATION a. NAME 5. PHYSICAL LOCATION OF EQUIPMENT a. ADDRESS (Room No., Building, Street, City, State, ZIP Code)

b. DSN TELEPHONE NUMBER

c. COMMERCIAL TELEPHONE NO. (Include area code) ( )

b. POINT OF CONTACT (If different from above)

c. TELEPHONE NO. (If different from above) ( )

6. EQUIPMENT TO BE EXCESSED
OSD CONTROL NO. a. ITEM COMP NO. CODE b. c. ITEM DESCRIPTION d. MFR CODE e. MODEL NO. f. SERIAL NO. g.
COND CODE h.

PRICE i.

7. I certify that all hard drives have been removed and equipment contains no magnetic media.

8. EQUIPMENT RECEIVED BY

9. DATE RECEIVED (MMDDYYYY)

SD FORM 811, OCT 2001

PREVIOUS EDITION IS OBSOLETE.

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