Minor Equipment Tag Request

Equipment Name: *

Description: *

Cost: *

Serial Number: *

Serial number of item (on Dell computer use Service Tag Number)

Model #: *

Manufacturer: *

Date Aquired: *

Month

Day

Year

Department: *

Building: *

Building equipment is housed in.

Room #: *

Room where equipment will be located

Speed Sort: *

Speed sort of building where equipment will be located.

Cost Center: *

Enter cost center item was charged to.

Employee Responsible: *

Employee using or responsible for this item.

Requested by: *

Your name.

Purpose:

Briefly describe the intended use of the equipment. (Maximum 500 characters)