Software License Verification



Windows

Macintosh |TRANSFER from previous computer or person (as applicable) |NEW/Current Assignment | |

|Date of installation |      |      |

|Name (first, last) |      |      |

|TxSt NetID (username) |      |      |

|Phone number |      |      |

|Department |      |      |

|Computer asset tag # |      |      |

|Current software title and publisher: |Version |Removed by |Installed by |

| | |(initials) |(initials) |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

Software media, license agreement, documentation (when applicable) have been transferred to the new assignee (computer or person).

I acknowledge having requested installation or having installed/transferred software on the above mentioned University computer. I certify that the software is properly licensed for the new installation and will/did remove from the previous computer (if applicable). I accept personal liability for the installation of this software. This software installation will not violate the rights of any party, including the rights of the Software licensor. I will indemnify Texas State and any installer, outside of myself, of any liability they may incur because of this software installation. I also understand that I must provide any media (e.g. diskettes or CDs) and software keys that may be required to accomplish this install. I acknowledge policy contained in UPPS 01.04.24 must be followed.

Signature of person removing/installing software Date

|From: | | |To: | |

|Dept |      | |Dept |      |

|Acct Mgr Signature | | |Acct Mgr Signature | |

|Print Name |      | |Print Name |      |

Use a University Department name, not a project or account name.

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