Precious Metal Source Request/Return Form

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This form is used to request (check-out) a precious metal source or to return (check-in) a source.

Name *

Badger Email Address *

Budget Number *

Advisor / Company Name *

What is the current or desired location for the precious metal source? *

PAN cubby/bin

Keller-Hall cubby/bin

Other (please provide more details in the "Additional Comments" box at the end of this form)

What is your bin number (for example, "Blue 42")? *

Precious Metal Source Type *

Gold-Palladium Alloy (Au/Pd)

Palladium (Pd)

Platinum (Pt)

Silver (Ag)

Gold 5N / 99.999

Are you checking out this source, or checking it back in? *

Check-Out ("I want to use it")

Check-In ("I want to return it")

If you are returning the source, please enter the starting weight of the source (in grams). If you are checking out this source, you can simply enter "0". *

If you are returning the source, please enter the ending weight of the source (in grams). If you are checking out this source, you can simply enter "0". *

Additional Comments (or delivery preferences)

Submit

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This form was created inside of University of Minnesota Twin Cities.

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