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PROPERTY REMOVAL AUTHORIZATION

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PROPERTY REMOVAL AUTHORIZATION
PROPERTY REMOVAL AUTHORIZATION
Please Print
This is to authorize _________________________________________________________________
(Name of Individual)
of
___________________________________________________________________________________
(Department)
Located in:
_________________________________________
(Building)
____________________ ,
(Room Number)
To remove the following listed item(s) from Albert Einstein College Medicine:
Description of Item(s) To Include Serial/Inventory Numbers:
____________________________________________________________
Signature of Authorized Department Supervisor
________________________________________
Print Name
.
_________________________
Telephone
________________
Date
Rev. 09/19/2013
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