REPLACEMENT DECISION FORM

____________________________ Circulation Unit
____________________________ Selector
____________________________ Technical Services Department


LOST/DAMAGED ___________ BILLED ___________ (If billed, charge replacement to BILRB fund)



Attach brief Gladis record or circulation card here




          Withdraw ___________ Return form to Circulation Unit
          Replace:

  1. Pick A, B, or C (check one option)

    1. Wanted regardless of CU holdings ___________

    2. Wanted unless MAIN has another copy of:
      this vol./no. ___________ this ed. ___________ latest ed. ___________ any ed. ___________

    3. Wanted unless CU has another copy of:
      this vol./no. ___________ this ed. ___________ latest ed. ___________ any ed. ___________

  2. For monographs, replace with (check one option)
    this ed. ___________ latest ed. ___________ any ed. ___________

  3. If out of print (select one or more options; options may be ranked)
    drop ________ search ________ acquire photoprint ________ acquire microform ________

FUND (use BILRB if billed) ___________

AUTHORIZED BY ____________________________ DATE ___________