University of Maine System s1

UNIVERSITY OF MAINE SYSTEM

REAL ESTATE ACQUISITIONS & DISPOSITIONS

REQUEST/APPROVAL FORM

CAMPUS PROPERTY ADDRESS (street address with number)

CITY STATE ZIP GRANTOR NAME(S) GRANTEE NAME(S)

PURCHASE PRICE OR VALUE – IF GIFT $

LAND AREA acres BUILDING AREA sq ft

ENVIRONMENTAL ASSESSMENT COMPLETED? YES NO Attach copy of Assessment

SITE PLAN AND/OR FLOOR PLAN REVIEWED? YES NO Attach a copy of plan(s)

TYPE OF TRANSFER DOCUMENT (warranty deed, quitclaim deed, easement, bequest, etc.)

ESTIMATED DATE OF TRANSFER

TAX MAP AND LOT

COMMENTS AND JUSTIFICATION FOR TRANSACTION

APPROVALS

Campus CFO Date:

UMS Risk Manager Date:

UMS Director of Facilities Date:

University Counsel Date:

r03/2007