Library Materials Discharge Form
Complete this form to document the removal of library materials from the collection.
Material Title
*
Material Type
*
Please Select
Book
Journal
DVD/CD
Manuscript
Map
Other
Author/Creator
Accession/Inventory Number
*
Department/Section
*
Please Select
General Collection
Reference
Media
Archives
Children’s Section
Other
Date of Discharge
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for Discharge
*
Please Select
Lost
Damaged
Outdated/Obsolete
Superseded by New Edition
Duplicate Copy
Other
Condition of Material at Discharge
*
Please Select
Good
Fair
Poor
Unusable
Staff Member Processing Discharge (Full Name)
*
First Name
Last Name
Staff Position/Role
*
Staff Email
*
example@example.com
Additional Comments or Notes
Submit
Submit Discharge
Should be Empty: