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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 ASSET# W4151875, 2003 CHEVY C4500 UTILITY BOX TRUCK <br />Asset Tag Number VEHICLE#509 <br />Department of Ownership WATER WORKS <br />Year of Acquisition 2002 <br />Historical Acquisition $ Value $30,245 <br />Net Book Value 0 <br />Reason for Disposal PAST USEFUL LIFE <br />Method of Disposal TRADE IN <br />Approval(s) Name Signature Date <br />Department Head 31 T 1 N V— ki N <br />Controller LI l <br />�o <br />AF Policy 2.5.1 Fixed Asset Form 1-B Request for Asset Disposal.doc Rev. 020810a <br />Page 1 of 1 <br />