Fixed Asset Acquisition/Change Form

This form must be completed for any fixed asset acquisition or disposal (includes any asset over $5000 and with useful life of at least 2 years) and acorresponding transmittal must be forwarded to the Comptroller. Fixed asset purchases may not be combined with non-fixed asset purchases on the same transmittal. Any changes must be also be submitted through this form indicating the appropriate changed information. (This includes changes in location, responsible party and disposal data). No transmittal is required on fixed asset changes. The following data is needed to process the acquisition/change:

Requestor:

Please Select One
Original Acquisition
Change to perm - Orig Tag#
Disposal of perm - Orig Tag#

Please Select One
NOTE: A component is associated with another asset but accounted for separately. An attachment is attached to another asset and will be combined with the parent asset records.
Stand alone asset
Component of perm -Tag#
Attached to perm -Tag#

Description of Asset:

Cost:

Insurance Value:

Market Value (Required on donations):

Replacement Value:

Book Value:

Method of Acquisition
Please select one:

Donated/Gift - If yes, provide name of donor:
Cash Purchase
Loaned
Lease Purchase
Purchase by Grant Funds - If yes, indicate fund # of grant:


Acquisition Date:

Make:

Model:

Manufacturer:

Serial number/VIN #*:

Vehicle Tag #:

BCCC Inventory Tag #:

Most current inventory date: (Only needed on changes, not new purchases)

Work in Progress: Yes No

Condition
Please select one:
Needs repair
Good Condition
Excellent Condition

Title Holder
Please select one:
BCCC
Fed Govt.
St Govt.
Lease Agency
BCCC Foundation
BCCC Booster Club

Disposal Method (only for disposals)
Please select one:
Traded in
Donated
Junked
Stolen
Lost
Sold (if sold, sales price
NOTE: please make sure proceeds are forwarded to the Comptroller)

Disposal Date:(only for disposals)

Location of Asset: (please be specific and indicate BANNER location code)

BANNER org responsible for asset:

Person responsible for asset:

Supervisor responsible for asset:

Estimated useful life*:

Estimated Salvage Value at disposition*:

To help keep spammers from using our forms you will have to type Barton below before submitting

Barton

*Required