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.tive 1-1-2010 <br />CITY OF SOUTH BEND <br />Request for Asset Disposal <br />Fixed Asset Disposal Procedure Statement <br />All city departments are required to submit asset disposal requests to the Board of Public Works for approval prior to <br />disposal of an asset. Asset disposal requests must include the following information: <br />Asset description <br />Asset Identification number <br />Year of acquisition <br />Historical acquisition value <br />Net book value <br />Reason for disposal <br />Method of disposal (offer for sale, scrap, etc.) <br />The asset disposal request must be signed by the Controller before submittal to the Board of Public Works. <br />Asset Description carp 661, 2013 Chevy Impala <br />Asset Tag Number 20130029 <br />Department of Ownership Police Dept <br />Year of Acquisition 2013 <br />Historical Acquisition $ Value 22939.66 <br />Net Book Value <br />11087.51 <br />Reason for Disposal accident -totaled <br />Method of Disposal will be auctioned or salvaged <br />Approval(s) Name Signature <br />Department Head <br />Controller <br />AF Policy 25.1 Fixed Asset Form 1.0 Request for Asset Disposal.doc <br />Page 1 of 7 <br />Date <br />Rev. 020810a <br />