Appendix 65

WASTE MATERIALS REPORT

Entity Name: _______________________ Fund Cluster: _____________
Place of Storage: _____________________ Date: _____________________
ITEMS FOR DISPOSAL
Item Quantity Unit Description Record of Sales
Official Receipt
No. Date Amount
1
2
3
4
5
6
7
8
9
10
TOTAL
Certified Correct : Disposal Approved
____________________________________ ____________________________________
Signature over Printed Name of Supply Signature over Printed Name of Head of
and/or Property Custodian Agency/Entity or his/her Authorized
Representative

Receivied Noted By:

By:

PORTENIO M. MERCADO BENNIE M. EVANGELISTA

ADMIN AIDE III HEAD, PROP, MGT.
(BODEGERO) SPMO SECTION SPMO

Date: Date:
CERTIFICATE OF INSPECTION

I hereby certify that the property enumerated above was disposed of as follows:
Item __________ Destroyed
Item __________ Sold at private sale
Item __________ Sold at public auction
Item __________ Trasfered without cost to (Name of the Agency/Entity)

Certified Correct: Witness to Disposal:

_____________________________ ____________________________
Signature over Printed Name of Inspection Signature over Printed Name of Witness
Officer