Property Disposal Form
To:
The Controller’s Office
Department:
Date:
Submitter Information
Name:
Phone Number:
Email:
Office Location:
 Request is hereby made for the disposal of the following listed University property.
Description
(Include serial numbers & model #)
Tag or decal #
Unit Cost of Each
Reason for disposal:
I, hereby affirm that (to the best of my knowledge and belief) the articles of property listed above were lost,
destroyed, damaged, or worn out in the manner stated and/or is surplus to this department.
_____________________________ Approved: _______________________________
Submitter Signature
Department head signature
 A copy of this report will be returned to the requesting department when approved by
the Controller’s office.
 Upon Approval from the Controller’s office:


If Facilities Management is to pick up the equipment, please issue a work order with
Facilities Management to schedule a pick-up at http://inside.mines.edu/Work-Order-2 .
If this is computer equipment, please contact the CCIT department at
http://help.mines.edu for removal of any hard drives prior to contacting Facilities
Management.
CONTROLLER’S OFFICE USE ONLY
Date of Disposal Approval:
______________________________
Approved by (Print Name): _____________________________________
Approval by Signature: _______________________________________
Property Disposal Form revised 02-2016