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(Signature over Printed Name of Accountable Officer) (Signature over Printed Name) ALBERTO C. PANTO, JR. KENN V. SORIA
(Designation of Accountable Officer) of Authorized
(Designation Official)
of Authorized Official) Property and Supply Officer IV State Auditor IV
Team Leader
Approved by:
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________ Transferred without cost to __(Name of the Agency/Entity)__
Certified Correct: Witness to Disposal:
Signature over Printed Name of Inspection Officer Signature over Printed Name of Witness