Capital Asset Coordinator Form — Inventory Control and Surplus Property

Department Name:

PS Department No. (10 digits):

Department Dean or Vice President

Submitted By:

E-Mail Address:

Phone No:

Assigned Capital Asset Coordinator The following employee has been assigned as our department Capital Asset Coordinator. I understand that the primary purpose of this individual is to coordinate our annual Capital Asset Inventory which must be submitted before December 15th.

Asset Coordinator's Name:

Coordinator's Email:

Phone No:

Supervisor's Name:

Phone No:

Department Head Name:

Phone No: