Request for temporary storage at Central Stores

Information and privacy: questions regarding the collection of information on this form can be directed to the form administrator.

Date: * (required)

Year

Month

Day

Department: * (required)

Requisitioner: * (required)

Phone / Ext.: * (required)

Email: * (required)

Material to be picked up from:

Building: * (required)

Department: * (required)

Room No. / Location: * (required)

Item 1:

Quantity: * (required)

Description: * (required)

Item 2:

Quantity:

Description:

Item 3:

Quantity:

Description:

Item 4:

Quantity:

Description:

Item 5:

Quantity:

Description:

Item 6:

Quantity:

Description:

Item 7:

Quantity:

Description:

Item 8:

Quantity:

Description:

Note:

Minimum 5 cartons stored
Maximum storage 2 years on non-records cartons
Records stored up to 7 years (age of records). Record dates must be shown on end of record cartons. Use only 40-0778 cartons.

Option 1:

Hold for how many months?

Then deliver to:

Phone / Ext.:

Option 2:

Dispose after holding for how many months?

Approved by: * (required)

Leave this field blank

Central Stores Business Operations - Monday to Friday, 7:30 am to 4:00 pm

Request for temporary storage at Central Stores