University Research Coordination Office: Turnover Form

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Ref.

# _______

Turnover Form

____________________

TO : University Research Coordination Office

FROM :

RE : Turnover of Equipment/Apparatus/Materials

***************************************************************************************************
Source of funds:
 Internal; Pls. specify ____________________________
 External; Pls. specify __________________

This is to certify that the following item/s which was/were purchased using funds from

Project No. : ___________________________________________________


Project Title : ___________________________________________________
Proponent(s) : ___________________________________________________
Department : ___________________________________________________

has/have been turned over to the ______________


This/These item/s is/are as follows:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

Cleared by ITS:
(Signature over Printed Name/Date)

Received by:
Department Chair
(Signature over Printed Name/Date)

Transfer Form #:

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