Penn State Department of Statistics


	Contact Information
First Name
Last Name
E-mail
Work Phone

	Item Information
Description (Item name & Vendor or Brand name)
Condition
Location (Room & Building)

PSU Tag?	Yes No
Tag #
Serial #
Model #

Disclaimers:

You will be charged for items left in the hallways that have not been dispositioned for salvage and surplus. By submitting this form, your items will be dispositioned for you.

http://guru.psu.edu/policies/psu/bs15.html

Items cannot contain hazardous materials. If you have materials that have been exposed to hazardous materials, it must be cleared for disposal by Environmental Health and Safety.

http://www.ehs.psu.edu/chem.html