P.O.
Box 1047 Addis Ababa Ethiopia
Department: DCCSM
Tel.: +251 (0) 115 515 700
www.ethiotelecom.et
Ethio Telecom Data Centre Service Request for Equipment Move-In/ Extraction
Hand Over Form
TO BE COMPLETED BY DATA CENTER COLOCATION CUSTOMERS
Data Center Location Old Airport
Company Name ZEMEN BANK
Requester Name Medrek Gebru
Requester ID Number 661
Requester Phone (Mobile/Office) 0910079032
Requester Signature
Requisition Date 10/14/2024
Date (Move-in/Out) ( MM/DD/YYYY) 10/14/2024
Equipment Move -in/Extracts Records (Must Be Filled)
Request Type Move IN Extract for Maintenance Extract for Permanent Withdrawal
No. Device Brand/Product Model Serial Number Rack #/ Remark
Position
1. Laptop Lenovo Core i7 PW0B9P76 15
Any additional notes pertinent to the request
Authorized Signature with Company Stamp
Internal Use Only
Sales Move-out /in ID Move-in/out Signature Date
Name & Title (DCCM Staff) granted Checked Granted
Yes No Yes No Yes No
Terms & Conditions
Only authorized representative(s)of the company/organization on the data center access authorization list
may make request to move-in/out equipment from the Data Center
The requester is required to observe and agree to abide by the Data Center Polices
The request form is valid for one week from the approval date.
Version: 1