REPORT ON THE PHYSICAL COUNT OF PROPERTY, PLANT AND EQUIPMENT

_____________________________________________________________
(Type of Property, Plant and Equipment)
As at ________________________________
Fund Cluster:
For which is accountable, having assumed such accountability on
(Name of Accountable Officer) (Official Designation) (Entity Name) (Date of Assumption)
QUANTITY QUANTITY
PROPERTY UNIT OF SHORTAGE/OVERAGE
ARTICLE DESCRIPTION UNIT VALUE per per REMAKS
NUMBER MEASURE
PROPERTY CARD PHYSICAL COUNT Quantity Value

Certified Correct by: Approved by: Verified by:

_______________________________
Signature over Printed Name of Signature over Printed Name of Head of Signature over Printed Name of
Inventory Committee Chair and Agency/Entity or Authorized Representative COA Representative
Members