Fixed Asset Transfer and Retirement Form

FORM: BOA-PM-TR001 Rev. 10/02/2007 Retire Code: Sale# TRANSFERS and RETIREMENTS SOUTH DAKOTA FIXED ASSET MAINTENANCE FORM

DATE: AGENCY: PROP MGMT OFFICER: CONTACT #:

If Reimbursable (CHECK HERE) ______Retire week of ______20 ___

Location of Property Property Mgmt LOG Number ASSET Number* (Example: Town / City or Bldg) (assigned by Property Management)

Asset Description *

Serial Number *

REQUIRED INFORMATION FOR ALL TRANSFERS AND RETIREMENTS L1 Level 2 (CAFR Reporting Group) * Original Cost* Acquire Date* Check One:

Check One: Retire (other than Surplus) ___ 100 General Fixed Asset Group $ __ __ Surplus 001 ___ 600 Internal Service Fund ___ 650 Enterprise Fund __ Transfer at no charge ___ 860 Non-Expendable Trust Fund to another Agency ___ 890 Pension Trust Fund (Receiving Agency fill in “TRANSFER ___ 900 Other/Amortization TO” information below)

Retire Date NOTES: Type Recap YYYY –MM

Fiscal Date Format. Default is current date C 1 200__ ___

“ TRANSFER TO” INFORMATION: *Must be completed by Receiving Agency Company/Fund* Program* Funding Source Sub Fund Level 4 Level 5 & 6 Level 7 Level 8 ______

INSTRUCTIONS: A tag must accompany all assets - excluding heavy equip, vehicles)

FOR MORE INFORMATION CONTACT: Property Management 773-4935 Complete this form to TRANSFER or RETIRE an existing Fixed Asset. A Property Management number will be assigned and a tag will be sent to Property Management Officer. THE TAG MUST BE AFFIXED TO THE ASSET PRIOR TO IT LEAVING YOUR AGENCY.