Request for Equipment Move

*All fields are required.

Today's Date:
Requestor's Name and Title:
Department:
Phone Number:
This is a request to have the following equipment moved.
1. Type of equipment to be moved
2. Requested date/time of move:
3. Name and title of person moving:
4. Employee's position code (for IT inventory purposes):
5. Current location (building and room number) of equipment:
6. Destination (building and room number) of equipment:
7. Computer/printer serial number(s) or telephone extension number(s):
8. Availability of furniture, data ports, electrical outlets, and telphone ports prior to move:
9. Confirmed Facilities Management move date:	*required