JAMES MADISON UNIVERSITY
RESTRICTED FUNDS – EQUIPMENT TITLE TRANSFER
THIS FORM IS DUE PRIOR TO THE ACTUAL TRANSFER!
JMU Dept ID #
(for Grant/Contract)
Principal Investigator
List equipment below with a detailed description:
Description (including item name, manufacturer, model #, serial #, JMU Decal No. ?)
1.
2.
3.
4.
The recipient,
, (name of agency receiving equipment from JMU) understands
and acknowledges that the equipment listed above is provided via restricted funds
received by James Madison University and it is to be used only in furtherance of the
purposes previously agreed upon. In addition, the recipient agrees to accept full
responsibility for all warranty, maintenance, insurance, and related issues associated
with the transfer of ownership for the above listed equipment.
Equipment Transfer authorized by: _____________________________ Date ______________
(signature of principal investigator)
Equipment received by __________________________________________ Date ______________
( typed name and title)
Form distribution:
Last Revised: 2/26/2004
Original to Plant Fund Accounting, MSC 5704
(1) Copy to Grant and Contract Accounting, MSC 5713
(1) Copy in Principal Investigator’s Grant/Contract File, MSC 5713
(1) Copy to Representative of Receiving Agency