CO-58 Revised 2-2016

STATE OF CONNECTICUT
PROPERTY TRANSFER WITHIN AGENCY
COMPLETE WHEN PROPERTY IS MOVED WITHIN AN AGENCY

AGENCY ACRONYM

AGENCY NAME

DATE

ITEM DESCRIPTION
(Include Material Content)

FROM

TAG NUMBER

TO

ADDRESS

ROOM NO.

ADDRESS

ROOM NO.

AUTHORIZED BY (Signature)

DATE

POSTED BY

DATE POSTED