F01 (10.33.

04)
Revision: 00
Eff. Dt.: 01.06.2021

ASSET RETIREMENT FORM No. ;-

Please complete Sections 1, 2 (one part only) and 3, for each disposed asset, using only CAPITAL LETTERS
SECTION 1: Origin and description of asset:
DISPOSING LOCATION : Section:-SECTION-II,SNG District:SED,SUNDARGARH Grid:33/11 COLLEGE GRID
CRAP STORE Substation :COLLEGE TRL Route Land Mark:- COLLEGE

ASSET DESCRIPTION: 33 KV VCB MAKE: BHEL

MODEL: NA SERIAL No: 9050735
DATE ACQUIRED: NA ORIGINAL COST: NA
WARRANTY PERIOD: NA LAST REPAIRED: NA
POST-DISPOSAL 33/11 KV GRID COLLEGE REASONS FOR DAMAGED
LOCATION: DISPOSAL:
WBS / SCHEME NO WORK ORDER NO
GENERATING ASSET GENE-RATING ASSET
DISPOSAL DISPOSAL

SECTION 2: Method of disposal

2.1 RETURNED FOR CREDIT: On completion of this & section 3 send the form to the Accounts Deptt.
Date returned:
To: (Vendor’s name) Vendor No.
Purchase order no: Amount received: R
Remarks:
2.2 LOST, STOLEN, OR DAMAGED BEYOND REPAIR: Complete this section and section 3.
Give details:
Date of incident: Insurance claimed? YES NO
 If no claim: Complete Section 3 and send this form direct to the Assets Office.
 If claimed: Complete Section 3 and send this form with the Insurance Claim Form to the Finance Deptt.
Accounts Deptt: Complete details below, process receipt, then send the original of this form to the Accounts Deptt. for
Retirement-processing.
Insurance claim no: Claim placed by:
Insurance company: Policy no:
Receipt no: Amount received:
Processed by: Date processed:
Remarks:
2.3 TRADED-IN: On completion of this & section 3 send the form to the Accounts Deptt.
Date traded-in: Purchase order no:
Vendor name: Amount received:
New asset Inventory no: New Asset Master no:
Remarks:
2.4 SOLD: On completion of this & section 3 send the form to the Accounts Deptt.
Customer name:
Customer no: Amount received:
Delivery note no: Invoice no:
Processed by: Date processed:
Remarks:

2.5 DISCARDED or DISMANTLED: On completion of this & section 3 send the form to the Accounts Deptt.
Date discarded: 5/9/2023
Give details: DISMANTLED AGAINST PSS UPGRADATION SCHEME.
Remarks: DEFECTIVE AND DISMANTLED AS IT IS BEYOND WARRANTY PERIOD.
SECTION 3: COMPLETION AND AUTHORISATION Both parts of this section must be completed by different persons.
3.1 FORM COMPLETED BY: Signature: Date:
Print name: Position:
3.2 DISPOSAL AUTHORISED BY: Signature: Date:
Print name: Position:

SECTION 4: RETIREMENT PROCESSING: (This section to be completed by the Accounts Deptt. only)
Retirement doc. no: Date processed:
Retirement
processed by:
 F01 (10.33.04)
Revision: 00
Eff. Dt.: 01.06.2021

ASSET RETIREMENT FORM No. ;-

Please complete Sections 1, 2 (one part only) and 3, for each disposed asset, using only CAPITAL LETTERS
SECTION 1: Origin and description of asset:
DISPOSING LOCATION : Section:-SECTION-II,SNG District:SED,SUNDARGARH Grid:33/11 COLLEGE GRID
CRAP STORE Substation :COLLEGE TRL Route Land Mark:- COLLEGE

ASSET DESCRIPTION: 33 KV CT MAKE: Universal Magnoflux (P) Ltd

MODEL: NA SERIAL No: 3475
DATE ACQUIRED: NA ORIGINAL COST: NA
WARRANTY PERIOD: NA LAST REPAIRED: NA
POST-DISPOSAL 33/11 KV GRID COLLEGE REASONS FOR DAMAGED
LOCATION: DISPOSAL:
WBS / SCHEME NO WORK ORDER NO
GENERATING ASSET GENE-RATING ASSET
DISPOSAL DISPOSAL

SECTION 2: Method of disposal

2.1 RETURNED FOR CREDIT: On completion of this & section 3 send the form to the Accounts Deptt.
Date returned:
To: (Vendor’s name) Vendor No.
Purchase order no: Amount received: R
Remarks:
2.2 LOST, STOLEN, OR DAMAGED BEYOND REPAIR: Complete this section and section 3.
Give details: Core and Stud of the CT stolen and only body is present(Complaint No.:-24507043072300068)
Date of incident: 23/10/2023 Insurance claimed? YES NO
 If no claim: Complete Section 3 and send this form direct to the Assets Office.
 If claimed: Complete Section 3 and send this form with the Insurance Claim Form to the Finance Deptt.
Accounts Deptt: Complete details below, process receipt, then send the original of this form to the Accounts Deptt. for
Retirement-processing.
Insurance claim no: Claim placed by:
Insurance company: Policy no:
Receipt no: Amount received:
Processed by: Date processed:
Remarks:
2.3 TRADED-IN: On completion of this & section 3 send the form to the Accounts Deptt.
Date traded-in: Purchase order no:
Vendor name: Amount received:
New asset Inventory no: New Asset Master no:
Remarks:
2.4 SOLD: On completion of this & section 3 send the form to the Accounts Deptt.
Customer name:
Customer no: Amount received:
Delivery note no: Invoice no:
Processed by: Date processed:
Remarks:

2.5 DISCARDED or DISMANTLED: On completion of this & section 3 send the form to the Accounts Deptt.
Date discarded: 5/9/2023
Give details: DISMANTLED AGAINST PSS UPGRADATION SCHEME.
Remarks: DEFECTIVE AND DISMANTLED AS IT IS BEYOND WARRANTY PERIOD.
SECTION 3: COMPLETION AND AUTHORISATION Both parts of this section must be completed by different persons.
3.1 FORM COMPLETED BY: Signature: Date:
Print name: Position:
3.2 DISPOSAL AUTHORISED BY: Signature: Date:
Print name: Position:

SECTION 4: RETIREMENT PROCESSING: (This section to be completed by the Accounts Deptt. only)
Retirement doc. no: Date processed:
Retirement
processed by:
 F01 (10.33.04)
Revision: 00
Eff. Dt.: 01.06.2021

ASSET RETIREMENT FORM No. ;-

Please complete Sections 1, 2 (one part only) and 3, for each disposed asset, using only CAPITAL LETTERS
SECTION 1: Origin and description of asset:
DISPOSING LOCATION : Section:-SECTION-II,SNG District:SED,SUNDARGARH Grid:33/11 COLLEGE GRID
CRAP STORE Substation :COLLEGE TRL Route Land Mark:- COLLEGE

ASSET DESCRIPTION: 33 KV CT MAKE: Universal Magnoflux (P) Ltd

MODEL: NA SERIAL No: 3477
DATE ACQUIRED: NA ORIGINAL COST: NA
WARRANTY PERIOD: NA LAST REPAIRED: NA
POST-DISPOSAL 33/11 KV GRID COLLEGE REASONS FOR DAMAGED
LOCATION: DISPOSAL:
WBS / SCHEME NO WORK ORDER NO
GENERATING ASSET GENE-RATING ASSET
DISPOSAL DISPOSAL

SECTION 2: Method of disposal

2.1 RETURNED FOR CREDIT: On completion of this & section 3 send the form to the Accounts Deptt.
Date returned:
To: (Vendor’s name) Vendor No.
Purchase order no: Amount received: R
Remarks:
2.2 LOST, STOLEN, OR DAMAGED BEYOND REPAIR: Complete this section and section 3.
Give details: Core and Stud of the CT stolen and only body is present(Complaint No.:-24507043072300068)
Date of incident: 23/10/2023 Insurance claimed? YES NO
 If no claim: Complete Section 3 and send this form direct to the Assets Office.
 If claimed: Complete Section 3 and send this form with the Insurance Claim Form to the Finance Deptt.
Accounts Deptt: Complete details below, process receipt, then send the original of this form to the Accounts Deptt. for
Retirement-processing.
Insurance claim no: Claim placed by:
Insurance company: Policy no:
Receipt no: Amount received:
Processed by: Date processed:
Remarks:
2.3 TRADED-IN: On completion of this & section 3 send the form to the Accounts Deptt.
Date traded-in: Purchase order no:
Vendor name: Amount received:
New asset Inventory no: New Asset Master no:
Remarks:
2.4 SOLD: On completion of this & section 3 send the form to the Accounts Deptt.
Customer name:
Customer no: Amount received:
Delivery note no: Invoice no:
Processed by: Date processed:
Remarks:

2.5 DISCARDED or DISMANTLED: On completion of this & section 3 send the form to the Accounts Deptt.
Date discarded: 5/9/2023
Give details: DISMANTLED AGAINST PSS UPGRADATION SCHEME.
Remarks: DEFECTIVE AND DISMANTLED AS IT IS BEYOND WARRANTY PERIOD.
SECTION 3: COMPLETION AND AUTHORISATION Both parts of this section must be completed by different persons.
3.1 FORM COMPLETED BY: Signature: Date:
Print name: Position:
3.2 DISPOSAL AUTHORISED BY: Signature: Date:
Print name: Position:

SECTION 4: RETIREMENT PROCESSING: (This section to be completed by the Accounts Deptt. only)
Retirement doc. no: Date processed:
Retirement
processed by:
 F01 (10.33.04)
Revision: 00
Eff. Dt.: 01.06.2021

ASSET RETIREMENT FORM No. ;-

Please complete Sections 1, 2 (one part only) and 3, for each disposed asset, using only CAPITAL LETTERS
SECTION 1: Origin and description of asset:
DISPOSING LOCATION : Section:-SECTION-II,SNG District:SED,SUNDARGARH Grid:33/11 COLLEGE GRID
CRAP STORE Substation :COLLEGE TRL Route Land Mark:- COLLEGE

ASSET DESCRIPTION: 33 KV CT MAKE: Universal Magnoflux (P) Ltd

MODEL: NA SERIAL No: Not Visible
DATE ACQUIRED: NA ORIGINAL COST: NA
WARRANTY PERIOD: NA LAST REPAIRED: NA
POST-DISPOSAL 33/11 KV GRID COLLEGE REASONS FOR DAMAGED
LOCATION: DISPOSAL:
WBS / SCHEME NO WORK ORDER NO
GENERATING ASSET GENE-RATING ASSET
DISPOSAL DISPOSAL

SECTION 2: Method of disposal

2.1 RETURNED FOR CREDIT: On completion of this & section 3 send the form to the Accounts Deptt.
Date returned:
To: (Vendor’s name) Vendor No.
Purchase order no: Amount received: R
Remarks:
2.2 LOST, STOLEN, OR DAMAGED BEYOND REPAIR: Complete this section and section 3.
Give details: Core and Stud of the CT stolen and only body is present (Complaint No.:-24507043072300068)
Date of incident: 23/10/2023 Insurance claimed? YES NO
 If no claim: Complete Section 3 and send this form direct to the Assets Office.
 If claimed: Complete Section 3 and send this form with the Insurance Claim Form to the Finance Deptt.
Accounts Deptt: Complete details below, process receipt, then send the original of this form to the Accounts Deptt. for
Retirement-processing.
Insurance claim no: Claim placed by:
Insurance company: Policy no:
Receipt no: Amount received:
Processed by: Date processed:
Remarks:
2.3 TRADED-IN: On completion of this & section 3 send the form to the Accounts Deptt.
Date traded-in: Purchase order no:
Vendor name: Amount received:
New asset Inventory no: New Asset Master no:
Remarks:
2.4 SOLD: On completion of this & section 3 send the form to the Accounts Deptt.
Customer name:
Customer no: Amount received:
Delivery note no: Invoice no:
Processed by: Date processed:
Remarks:

2.5 DISCARDED or DISMANTLED: On completion of this & section 3 send the form to the Accounts Deptt.
Date discarded: 5/9/2023
Give details: DISMANTLED AGAINST PSS UPGRADATION SCHEME.
Remarks: DEFECTIVE AND DISMANTLED AS IT IS BEYOND WARRANTY PERIOD.
SECTION 3: COMPLETION AND AUTHORISATION Both parts of this section must be completed by different persons.
3.1 FORM COMPLETED BY: Signature: Date:
Print name: Position:
3.2 DISPOSAL AUTHORISED BY: Signature: Date:
Print name: Position:

SECTION 4: RETIREMENT PROCESSING: (This section to be completed by the Accounts Deptt. only)
Retirement doc. no: Date processed:
Retirement
processed by:
 F01 (10.33.04)
Revision: 00
Eff. Dt.: 01.06.2021

ASSET RETIREMENT FORM No. ;-

Please complete Sections 1, 2 (one part only) and 3, for each disposed asset, using only CAPITAL LETTERS
SECTION 1: Origin and description of asset:
DISPOSING LOCATION : Section:-SECTION-II,SNG District:SED,SUNDARGARH Grid:33/11 COLLEGE GRID
CRAP STORE Substation :COLLEGE TRL Route Land Mark:- COLLEGE

ASSET DESCRIPTION: Switchgear MAKE: BHEL

MODEL: NA SERIAL No: BP9050945
DATE ACQUIRED: NA ORIGINAL COST: NA
WARRANTY PERIOD: NA LAST REPAIRED: NA
POST-DISPOSAL 33/11 KV GRID COLLEGE REASONS FOR DAMAGED
LOCATION: DISPOSAL:
WBS / SCHEME NO WORK ORDER NO
GENERATING ASSET GENE-RATING ASSET
DISPOSAL DISPOSAL

SECTION 2: Method of disposal

2.1 RETURNED FOR CREDIT: On completion of this & section 3 send the form to the Accounts Deptt.
Date returned:
To: (Vendor’s name) Vendor No.
Purchase order no: Amount received: R
Remarks:
2.2 LOST, STOLEN, OR DAMAGED BEYOND REPAIR: Complete this section and section 3.
Give details: Copper flat stolen
Date of incident: 30/01/2024 Insurance claimed? YES NO
 If no claim: Complete Section 3 and send this form direct to the Assets Office.
 If claimed: Complete Section 3 and send this form with the Insurance Claim Form to the Finance Deptt.
Accounts Deptt: Complete details below, process receipt, then send the original of this form to the Accounts Deptt. for
Retirement-processing.
Insurance claim no: Claim placed by:
Insurance company: Policy no:
Receipt no: Amount received:
Processed by: Date processed:
Remarks:
2.3 TRADED-IN: On completion of this & section 3 send the form to the Accounts Deptt.
Date traded-in: Purchase order no:
Vendor name: Amount received:
New asset Inventory no: New Asset Master no:
Remarks:
2.4 SOLD: On completion of this & section 3 send the form to the Accounts Deptt.
Customer name:
Customer no: Amount received:
Delivery note no: Invoice no:
Processed by: Date processed:
Remarks:

2.5 DISCARDED or DISMANTLED: On completion of this & section 3 send the form to the Accounts Deptt.
Date discarded: 25/01/2024
Give details: DISMANTLED AGAINST PSS UPGRADATION SCHEME.
Remarks: DEFECTIVE AND DISMANTLED AS IT IS BEYOND WARRANTY PERIOD.
SECTION 3: COMPLETION AND AUTHORISATION Both parts of this section must be completed by different persons.
3.1 FORM COMPLETED BY: Signature: Date:
Print name: Position:
3.2 DISPOSAL AUTHORISED BY: Signature: Date:
Print name: Position:

SECTION 4: RETIREMENT PROCESSING: (This section to be completed by the Accounts Deptt. only)
Retirement doc. no: Date processed:
Retirement
processed by:
 F01 (10.33.04)
Revision: 00
Eff. Dt.: 01.06.2021

ASSET RETIREMENT FORM No. ;-

Please complete Sections 1, 2 (one part only) and 3, for each disposed asset, using only CAPITAL LETTERS
SECTION 1: Origin and description of asset:
DISPOSING LOCATION : Section:-SECTION-II,SNG District:SED,SUNDARGARH Grid:33/11 COLLEGE GRID
CRAP STORE Substation :COLLEGE TRL Route Land Mark:- COLLEGE

ASSET DESCRIPTION: Switchgear MAKE: BHEL

MODEL: NA SERIAL No:
DATE ACQUIRED: NA ORIGINAL COST: NA
WARRANTY PERIOD: NA LAST REPAIRED: NA
POST-DISPOSAL 33/11 KV GRID COLLEGE REASONS FOR DAMAGED
LOCATION: DISPOSAL:
WBS / SCHEME NO WORK ORDER NO
GENERATING ASSET GENE-RATING ASSET
DISPOSAL DISPOSAL

SECTION 2: Method of disposal

2.1 RETURNED FOR CREDIT: On completion of this & section 3 send the form to the Accounts Deptt.
Date returned:
To: (Vendor’s name) Vendor No.
Purchase order no: Amount received: R
Remarks:
2.2 LOST, STOLEN, OR DAMAGED BEYOND REPAIR: Complete this section and section 3.
Give details: Copper Flat Stolen
Date of incident: 30/01/2024 Insurance claimed? YES NO
 If no claim: Complete Section 3 and send this form direct to the Assets Office.
 If claimed: Complete Section 3 and send this form with the Insurance Claim Form to the Finance Deptt.
Accounts Deptt: Complete details below, process receipt, then send the original of this form to the Accounts Deptt. for
Retirement-processing.
Insurance claim no: Claim placed by:
Insurance company: Policy no:
Receipt no: Amount received:
Processed by: Date processed:
Remarks:
2.3 TRADED-IN: On completion of this & section 3 send the form to the Accounts Deptt.
Date traded-in: Purchase order no:
Vendor name: Amount received:
New asset Inventory no: New Asset Master no:
Remarks:
2.4 SOLD: On completion of this & section 3 send the form to the Accounts Deptt.
Customer name:
Customer no: Amount received:
Delivery note no: Invoice no:
Processed by: Date processed:
Remarks:

2.5 DISCARDED or DISMANTLED: On completion of this & section 3 send the form to the Accounts Deptt.
Date discarded: 25/01/2024
Give details: DISMANTLED AGAINST PSS UPGRADATION SCHEME.
Remarks: DEFECTIVE AND DISMANTLED AS IT IS BEYOND WARRANTY PERIOD.
SECTION 3: COMPLETION AND AUTHORISATION Both parts of this section must be completed by different persons.
3.1 FORM COMPLETED BY: Signature: Date:
Print name: Position:
3.2 DISPOSAL AUTHORISED BY: Signature: Date:
Print name: Position:

SECTION 4: RETIREMENT PROCESSING: (This section to be completed by the Accounts Deptt. only)
Retirement doc. no: Date processed:
Retirement
processed by:
 F01 (10.33.04)
Revision: 00
Eff. Dt.: 01.06.2021

ASSET RETIREMENT FORM No. ;-

Please complete Sections 1, 2 (one part only) and 3, for each disposed asset, using only CAPITAL LETTERS
SECTION 1: Origin and description of asset:
DISPOSING LOCATION : Section:-SECTION-II,SNG District:SED,SUNDARGARH Grid:33/11 COLLEGE GRID
CRAP STORE Substation :COLLEGE TRL Route Land Mark:- COLLEGE

ASSET DESCRIPTION: MAKE:

MODEL: NA SERIAL No:
DATE ACQUIRED: NA ORIGINAL COST: NA
WARRANTY PERIOD: NA LAST REPAIRED: NA
POST-DISPOSAL 33/11 KV GRID COLLEGE REASONS FOR DAMAGED
LOCATION: DISPOSAL:
WBS / SCHEME NO WORK ORDER NO
GENERATING ASSET GENE-RATING ASSET
DISPOSAL DISPOSAL

SECTION 2: Method of disposal

2.1 RETURNED FOR CREDIT: On completion of this & section 3 send the form to the Accounts Deptt.
Date returned:
To: (Vendor’s name) Vendor No.
Purchase order no: Amount received: R
Remarks:
2.2 LOST, STOLEN, OR DAMAGED BEYOND REPAIR: Complete this section and section 3.
Give details:
Date of incident: Insurance claimed? YES NO
 If no claim: Complete Section 3 and send this form direct to the Assets Office.
 If claimed: Complete Section 3 and send this form with the Insurance Claim Form to the Finance Deptt.
Accounts Deptt: Complete details below, process receipt, then send the original of this form to the Accounts Deptt. for
Retirement-processing.
Insurance claim no: Claim placed by:
Insurance company: Policy no:
Receipt no: Amount received:
Processed by: Date processed:
Remarks:
2.3 TRADED-IN: On completion of this & section 3 send the form to the Accounts Deptt.
Date traded-in: Purchase order no:
Vendor name: Amount received:
New asset Inventory no: New Asset Master no:
Remarks:
2.4 SOLD: On completion of this & section 3 send the form to the Accounts Deptt.
Customer name:
Customer no: Amount received:
Delivery note no: Invoice no:
Processed by: Date processed:
Remarks:

2.5 DISCARDED or DISMANTLED: On completion of this & section 3 send the form to the Accounts Deptt.
Date discarded:
Give details: DISMANTLED AGAINST PSS UPGRADATION SCHEME.
Remarks: DEFECTIVE AND DISMANTLED AS IT IS BEYOND WARRANTY PERIOD.
SECTION 3: COMPLETION AND AUTHORISATION Both parts of this section must be completed by different persons.
3.1 FORM COMPLETED BY: Signature: Date:
Print name: Position:
3.2 DISPOSAL AUTHORISED BY: Signature: Date:
Print name: Position:

SECTION 4: RETIREMENT PROCESSING: (This section to be completed by the Accounts Deptt. only)
Retirement doc. no: Date processed:
Retirement
processed by:
 F01 (10.33.04)
Revision: 00
Eff. Dt.: 01.06.2021