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2. ADDITION TO Department:
4. Department:
6. Location:
10. EQUIPMENT DETAILS
12. Date asset placed in service:
    Date asset placed in service:
13. Make/Model #:
15. V.I.N. or Serial #:
16. Purchase Price
18. Asset Description:
20. Vendor Name:
21. Phone Number:
22. Vendor Number:
26. ADDITION DETAILS
28. Signature of Department Head:
29. Date:
    Date:
31. Additional Information:
    Identify and include the cost of any additional equipment installed in order to place the asset in service, such as radio, wench, light bars, etc:
35. CITY OF DURANT-CITY CLERK AND CITY TREASURER OFFICE USE ONLY
37. Form Received From Department By:
38. Date:
    Date:
40. Asset Number Assigned:
42. Asset Addition Complete in the Following Records: (initials and date)
44. Insurance:
45. Fixed Assets:
46. General Ledger:
48. G.L. Fund and Department Number:
Leave This Blank:


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50. Email address

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