ASMA – Home Use Authorization Form
Form # DPP-ASMA-003-2024 Approved 04-12-04 Revised 1-1-2024 Comm. of Prop. Proc. Date: Other: Emergency Phone No. Asset ID No./*Condition Code E - Excellent G - Good F - Fair P - Poor U - Unusable L - Lost S - Stolen X - Surplus Instructions for Return: Use retained original, complete bottom portion of form and return to the respective Agency Head's Office. The Departmental Accountable Officer should also retain a copy of this form. Complete Upon Return of Equipment The equipment listed above has been returned. User's Signature & Date: Print Name/Title: Verified by (Sign & Date): Approved by (Sign & Date): Instructions for Initial Authorization: Complete and send original to the respective Agency Head's Office until the equipment is returned. The Departmental Accountable Officer should also retain a copy of this form. * Condition Code: *Condition Codes: Serial No. Name of User Justification for Home Use: Print Name/Title: User's Signature & Date: Annual Renewal To Be Returned: Government of the U.S. Virgin Islands HOME USE AUTHORIZATION Authorization No. …
Download the original document · Plain text (TXT) · Browse the archive · How this archive works
Original source: https://dpp.vi.gov/wp-content/uploads/2023/11/ASMA-Home-Use-Authorization-Form.pdf
SHA-256 ad18ede939a169c8c23e6b6e0e363c2f84ffd25ed822d3eb8db0355141e920db
Re-using this document
A public record of the Government of the Virgin Islands, published by the agency itself. No copyright is asserted on it and 17 U.S.C. § 105 does not reach territorial government, so it publishes as a territorial public record.
Our description, tagging, arrangement, extracted text and machine transcripts are released under CC0 1.0. We assert nothing about the document itself.
Archive identifier LF-ad18ede939a1
Document text
Form # DPP-ASMA-003-2024 Approved 04-12-04 Revised 1-1-2024 Comm. of Prop. Proc. Date: Other: Emergency Phone No. Asset ID No./*Condition Code E - Excellent G - Good F - Fair P - Poor U - Unusable L - Lost S - Stolen X - Surplus Instructions for Return: Use retained original, complete bottom portion of form and return to the respective Agency Head's Office. The Departmental Accountable Officer should also retain a copy of this form. Complete Upon Return of Equipment The equipment listed above has been returned. User's Signature & Date: Print Name/Title: Verified by (Sign & Date): Approved by (Sign & Date): Instructions for Initial Authorization: Complete and send original to the respective Agency Head's Office until the equipment is returned. The Departmental Accountable Officer should also retain a copy of this form. * Condition Code: *Condition Codes: Serial No. Name of User Justification for Home Use: Print Name/Title: User's Signature & Date: Annual Renewal To Be Returned: Government of the U.S. Virgin Islands HOME USE AUTHORIZATION Authorization No. Division Location Department/Agency/Bureau Description of Equipment Work Phone No. PRINT IN DUPLICATE