Annex A.

1
SEMI EXPENDABLE PROPERTY CARD

Entity Name: _________________________________________ Fund Cluster : _____________________

Semi-expendable Property: Semi-expendable Property Number: _______________

Description:

Receipt Issue/ Transfer/ Diposal Balance

Date Reference Amount Remarks
Qty. Unit Cost Total Cost Item No. Qty. Office/ Officer Qty.
 Annex A.2
SEMI EXPENDABLE PROPERTY LEDGER CARD

Entity Name: _________________________________________ Fund Cluster : _____________________

Semi-expendable Property: Semi-expendable Property Number: _______________

Description:
UACS Object Code: Repair History

Receipt Accumulated
Issues/ Transfers/
Date Reference Impairment Adjusted Cost Nature of Repair Amount
Adjusment/s
Qty. Unit Cost Total Cost Losses
 Annex A.3

INVENTORY CUSTODIAN SLIP

Entity Name:
Fund Cluster : ICS No : ______________
Amount
Estimated
Quantity Unit Unit Description Item No.
Total Cost Useful Life
Cost

Received from: Received by:

Signature Over Printed Name Signature Over Printed Name

Position/Office Position/Office

Date Date
 Annex A.4
REGISTRY SEMI EXPENDABLE PROPERTY ISSUED

Entity Name: _________________________________________ Fund Cluster : _____________________

Reference Issued Returned Re--issued Diposal Balance

Date Item Description Estimated Useful Life Amount Remarks
Semi-expendable Property
ICS/RRSP No. Qty. Office/ Officer Qty. Office/ Officer Qty. Office/ Officer Qty. Qty.
No.
 Annex A.5
INVENTORY TRANFER REPORT

Entity Name: ___________________________________ Fund Cluster: _____________

From Accountable Officer/Agency/Fund Cluster __________________________________ ITR : _____________________
To Accountable Officer/Agency/Fund Cluster __________________________________ Date : ____________________
Transfer Type: (check only one)
Donation Relocate
Reassignment Others (Specify) ______________
Condition of
Date Acquired Item No. ICS No./Date Description Amount
Inventory

Reason/s for Transfer

Approved by: Released/Issued by: Received by:

Signature: ___________________________ _____________________________________ _____________________________

Printed Name: ___________________________ _____________________________________ _____________________________
Designation: ___________________________ _____________________________________ _____________________________
Date: ___________________________ _____________________________________ _____________________________
 Annex A.6

RECEIPT OF RETURED SEMI-EXPENDABLE PROPERTY

Entity Name: Date:

RRSP No.:
This is to acknowledge receipt of the returned Semi-expendable Property
Item Description Quantity ICS NO. End-user Remarks

Returned by: Received by:

__________________________ __________________________________________
End User Head, Property and/or Supply Division/ Unit
___________________________ ___________________________
Date Date
 Annex A.7

REPORT OF SEMI-EXPENDABLE PROPERTY ISSUED

Entity Name: Serial No. : _____________________

Fund Cluster : Date : _______________________
To be filled by the Property and/ or Supply Division/ Unit To be filed out by the Accounting Division / Unit

Semi-
ICS Responsibility Quantity
expendable Item Description Unit Unit Cost Amount
No. Center Code Issued
Property No.

Posted by:
I hereby certify to the correctness of the above information.

_____________________________________________________ ____________________
Signature over Printed Name __________
Signature Over Printed Name of Property and/ or Supply Custodian of Designated Accounting
Staff
 Annex A.8

REPORT ON THE PHYSICAL COUNT OF SEMI-EXPENDABLE PROPERTY

_________________________________
(Type of Semi-expendable Property)

As at __________________

Fund Cluster : ________________________________

For which _(Name of Accontable Officer), (Official Desiganation)_, _(Entity Name) is accountable, having assumed such accountability on (Date of Assumption).

Semi- On Hand Per Shortage/Overage

Unit of
Article Description expendable Unit Value Balance Per Card Count Remarks
Measure
Property No. (Quantity) (Quantity) 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 COA
Inventory Committee Chair and Agency/Entity or Authorized Representative Representative
Members
### Annex A.9

REPORT OF LOST, STOLEN, DAMAGED OR DESTROYED SEMI-EXPENDBLE

PROPERTY
Entity Name : Fund Cluster: ______________
Department/Office: RLSDDP No. : _____________
Accountable Officer : RLSDDP Date : __________
Designation : ICS No. : __________
Police Notified : Yes Police Station: ________________ ICS Date : __________
No Date: _______________
Status of Property : (check applicable box)
Lost Damaged
Stolen Destroyed

Property No. Description Acquisition Cost

Circumstances:

I hereby certify that the item/s and circumstances stated above are true
and correct. Noted by:

______________________________________________ _________________________________
Signature over Printed Name of the Accountable Officer Signature over Printed Name of the School
Property Immediate Supervisor
________________________________ _________________________
Date Date

Government Issued ID:

ID No.:
Date Issued:

SUBSCRIBED AND SWORN to before me this _________ day of ____________________, affiant exhibiting
the above government issued identification card.

Doc. No. _______

Page No. _______ __________________________
Book No. _______ Notary Public
Series of _______
 INVENTORY AND INSPECTION REPORT OF UNSERVICEABLE SEMI-EXPENDABLE PROPERTY
As at
Entity Name: _______________________________________ Fund Cluster : _____________________
____________________________________________
(Name of Accountable Officer) (Designation) (Station)

INVENTORY INSPECTION and DISPOSAL

Semi- DISPOSAL RECORD OF SALES

Accumulated
Date Particulars/ expendable Unit Total Accumulated Carrying Appraised
Qty Impairment Remarks
Acquired Articles Property Cost Cost Depreciation Amount Other Value
Losses Sale Transfer Destruction Total OR No. Amount
No.
(Specify)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18)
###

I CERTIFY that I have inspected each I CERTIFY that I have

I HEREBY request inspection and disposition, pursuant to Section 79 of PD 1445, of the property enumerated and every article enumerated in this report, witnessed the disposition of the
above. and that the disposition made thereof was, in articles enumerated on this report
my judgment, the best for the public interest. this ____day of _____________,
_____.

Requested by: Approved by:

(Signature over Printed Name of (Signature over Printed Name of (Signature over Printed Name of Inspection (Signature over Printed Name of
Accountable Officer) Authorized Official) Officer) Witness)

(Designation of Accountable Officer) (Designation of Authorized Official)