This form is to be used for Emergency Replacement Requests.
(Process reserved for replacement when hardware is out of warranty and repair cost is over 40% of the new item.)

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example: jerne.murray@hccs.edu

select from the dropdown

preferred replacement model - if you know

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Person that will be custodian of this hardware

When is this Request expected?

Asset Tag of the hardware that is to be replaced.
Enter N/A if item has no Asset Tag

Serial Number of the hardware that is to be replaced

upload additional documents if needed

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