Annex 51

GF # 17-A (2) Control no:

INVENTORY AND INSPECTION REPORT OF UNSERVICEABLE PROPERTY

As of _________________________________

( LGU ) (Name of Accountable Officer) (Designation) (Station)

INVENTORY INSPECTION REPORT

FUND DISPOSITION Official
No. of Accumul
Date years ated Appraisal Receipt Amount
CODE SOURCE in Deprecia
Articles Quantity Unit Cost Total Cost Property No. Acquired service tion Number
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16)

I HEREBY request inspection, and disposition I CERTIFY that I have inspected

pursuant to Section 79 of PD 1445, of the property each and I CERTIFY that I have witnessed the
every article enumerated in this report
enumerated above. and that disposition of the articles enumerated on this
the disposition made thereof was, in my report this ___ day of ___________, ____.
judgement,
Requested by: Approved by:

(Signature of Accountable Officer) (Name and Signature)

(Name and Signature of Inspector) (Name and Signature of Witness)

(Designation of Accountable Officer) (Designation)