PRE-ADMIN CLEARANCE FORM

ADMIN DOC CONTROL #

EMPLOYEE NAME: EMPLOYEE ID NUMBER:
TITLE POSITION: DATE FILED: Asset turnover recipient's Name:
DEPARTMENT & LOCATION Immediate Superior/s:
Assigned Facilities Admin Officer's Name:
ASSET TURN OVER RECORD
TRANSACTION N/A YES NO Turned Over to DATE FAO Remarks
* ID Card Returned
* Uniforms Returned
* Filing Cabinet Keys Returned
Item Description SERIAL # ASSET TAG # CONDITION Turned Over to DATE FAO Remarks

Please attached file for mutliple assets

PRE-ADMIN CLEARANCE APPROVAL:
Facitlies Admin Officer Senior Facitlies Admin Officer Asset & Liquidation Supervisor IT REPRESENTATIVE FINAL RECOMMENDATION:
Name: Name: Name: Name:
Signature: Signature: Signature: Signature:
Date: Date: Date: Date: