Surplus Request Form

Please Note: SWAP only picks up items from UW Departments and Local State Agencies
See Purchasing Policy and Procedures #18 for further information


Is this a Pick-Up or a Drop-Off?


(Please submit this form at least 24 hours before dropping off your items)
Please complete all information below or your form will not be processed.

(required)

The University can only return the net proceeds from the sale of these items to your department if the following statement is true:

The assets being sold were originally purchased with grant or gift funds, OR the assets being sold are being replaced, OR they have recently been replaced, OR the functionality has been replaced.


Description of Equipment

Description of
Equipment
Description of
Equipment Condition
Mfr's Serial / UW
Inventory Number
Suggested
Current Value
Originally 144
Funds (Y/N)
Funding String
(144 Funds Only)

Additional Comments:

I understand that:

*If you checked "Yes" stating that an item was originally purchased with 144 funds, you must provide the funding string for that item.

Please print a copy of this form for your records and press SUBMIT.