Please use BLOCK letters and complete all fields This form is to be used when assets are transferred from one Responsibility Centre to another.
Responsibility Centre Account Code: Name of receiving Unit: Name of Receiving Contact Officer: Phone: Item description(s):
Project/Grant
Asset ID Number: Asset Tag Number: Serial Number: Approval by Financial Delegations: Name: Signature: Date: to be completed by receiving Department/Unit
Project/Grant
Acknowledge Receipt
(Asset received in good condition by) Sign & Date
Designation
Designation
Designation
Designation