Request to Dispose of State Property

Fill out form, (tab to the next field), print off and mail to: Dana M. Danielson, Inventory Coordinator, CR #37

Date of Request:

Description of Item:


State Asset # Sticker: (if none, please indicate none)

Serial # of Item:

Model # of Item:

Condition of Item:

Reason for Disposal:

Your Name and Title:

Department and Phone Number:

Do not dispose of state property until you receive approval and instructions to do so.
Submit completed form to:
Dana M. Danielson
Inventory Coordinator, CR #37
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