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$OUTli e� <br />City of South Bend <br />V "r� Request for Asset Disposal <br />xsss <br />Fixed Asset Disposal Procedure Statement <br />All city departments are required to submit as disposal requests to the Board of Public Works for approval prior <br />to 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 # - Improvement # 60000062-0000 Acquisition Date 01105/2008 <br />Description COMMUNITY DEVELOPMENT IMAGING INTERFACE <br />Serial Number NIA <br />Tag/Reference. Number NIA <br />Asset Type CM - ComputerstPeripherais <br />Reason for Disposal: <br />Method of Disposal: Obsolete <br />Purchase Cost $ 10,777.60 <br />(historical acquisition value) <br />Net Book Value $ - <br />(purchase price minus depreciaGbn) <br />Current Location Code CC139 - CODE ENFORCEMENT <br />Approvals <br />Name <br />gnature <br />Date <br />Department Head <br />Randy Wilkerson <br />Controller <br />Jennifer Hockenhull <br />f �- <br />u <br />Fixed Asset Form 1-B Request for Asset Disposal 1 of 1 <br />