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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 <br />Asset Tag Number <br />Department of Ownership <br />Year of Acquisition <br />car# 3142, 2004 Chevy Impala <br />00009139 <br />Police Dept <br />2004 <br />Historical Acquisition$ Value $18,823 <br />Net Book Value <br />Reason for Disposal <br />Method of Disposal <br />past useful Iffe <br />Auction 8/27/16 <br />Approval(s) <br />Name <br />Signature <br />Department Head <br />�r� �• <br />r�A �mJ <br />c <br />Controller <br />J d 1 <br />AF Policy 2.5.1 fixed Asset Form 1-13 Request for Asset Disposal.doc <br />Page 1 of 1 <br />Date <br />-- & <br />R -,i( (, fa ..— <br />Rev. 020810a <br />