Charles county public schools technology equipment damage or loss form

CHARLES COUNTY PUBLIC SCHOOLS

TECHNOLOGY EQUIPMENT DAMAGE OR LOSS FORM

 

DAMAGE LOSS / THEFT

SECTION 1 (to be completed by person who discovered loss/damage)

Name of employee: School/Department: Date:

Helpdesk Ticket #: ___________________ Description of damage:

Description of incident:

Employee signature Date

SECTION 2 (to be completed by Computer Analyst / Department of Technology)

Type of equipment: Manufacturer:

Model: Serial #:

Fixed Asset barcode #: Repair/Replacement cost:

Computer Analyst signature / Technology Date

Principal/Supervisor signature Date

Office of Instruction signature Date

Transfer Expense Form

SECTION 3 (to be completed by Office of Instruction / Department of Technology)

Department Initiating Request: Technology

FROM ORIGINAL TECH ACCOUNT NUMBER:

TO NEW ACCOUNT NUMBER (SCHOOL):

AMOUNT TO BE ADJUSTED:

JUSTIFICATION (Reason for the correction): To cover expense(s) described in section 1.

Date sent to Instruction: Spreadsheet updated:

Date emailed to School/Center/Office: Spreadsheet updated:

Date sent to B&F: Spreadsheet updated:

Date notified helpdesk to repair/replace equipment: Spreadsheet updated: