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Indiana University Bloomington

Technology Services

Workstation Retrieval Consent Form


Technology Operations & Services Workstation Retrieval Consent Form


Before Technology Operations & Services can take possession of IU Tag Number ____________for reallocation and or retirement, we must have a responsible party read and sign this form.


The computer listed above will be re-imaged. The process of re-imaging the machine will result in a TOTAL LOSS OF DATA (no data/information that was on the PC will be recoverable)


By signing below, I acknowledging that this machine will be reallocated and or retired from inventory resulting in total loss of data.


Name _________________________________   Date ____________


Computer Name __________________________________


Username ________________


IU Tag Number ____________


Last Modified 4/11/2010