CALIFORNIA DEPARTMENT OF EDUCATION CAREER AND COLLEGE TRANSITION DIVISION

Certification: I hereby certify that federal 34 CFR Section 80.32 and Education Code 35168 equipment-management regulations have been met and that the equipment listed is no longer used in the CTE programs/services for which it was purchased and request its removal from the LEA equipment inventory.

Return form to:
CTE Administration and Management Office
California Department of Education
1430 N Street, Suite 4202
Sacramento, CA 95814
Telephone: 916-324-5706

LEA Name:

LEA Address:

CDE Approval by:

Printed Name of Authorized Representative:

 Title:

Title:

Original Signature of Authorized Representative:

 Date:

 Date:

Equipment Description

Equipment I.D. #

Funding

Source

Acquisition

Date

Acquisition

Cost

Trade–in

Appraisal

Value

Reason for Removal