Declaration Of Vehicle Surplus Form printable pdf download

Declaration Of Vehicle Surplus Form

Pepperdine University ~ Declaration

of Vehicle Surplus, Form

(06/09)

Instructions:

Fill Form out completely and forward to Warehouse Services via campus mail.

Department:__________________________________________________, phone extension: _____________

Account # _________-_______________________-__________________

note, if there are any disposal costs associated with this vehicle, those costs will need to be paid for by the department

Please

Authorized department/budget manager approval

(mandatory)

signature_________________________________________________ Date: ____/____/____

print name___________________________________________________________________

Vehicle information: VIN #___________________________________________ CA Lic. #_______________

Pepperdine Vehicle ID#_________________, Mileage __________________, Color______________

Vehicle condition: Body:_____________________________________________________________________

Tires/Brakes:___________________________ Gen. Operation:________________________

(does it start and run, etc.)

………………………………………………………………………………………………………………………

FOR USE BY WAREHOUSE AND AUTO SHOP –ONLY

Vehicle condition/operation verification, by: _____________________________________________________

Drivability:________________________________________________________________________________

Safe:_____________________________________________________________________________________

Legal operations:___________________________________________________________________________

Reviewed and confirmed by:_______________________________________________ Date:______________

Legal documents:

Pink Slip/date_______________, Liability Release/date________________

Bill of Sale/date______________, Smog Certificate date_______________

Vehicle Final Status:

Transferred: ____ To Department_______________, Sold Date:_______________, Junked Date:___________

DOC: Vehicle Surplus Form

Declaration Of Vehicle Surplus Form