STOCK CARD

Entity Name: ________________________________ Fund Cluster: _________________

Item : Stock No. :

Description : Re-order Point :
Unit of Measurement :
Receipt Issue Balance
Date Reference
Qty. Qty. Office Qty.
 Appendix 58

ster: _________________

No. of Days to Consume

 Appendix 59

INVENTORY CUSTODIAN SLIP

Entity Name: _________________________________

Fund Cluster : ________________________________ ICS No : ______________

Amount
Inventory
Quantity Unit Description
Unit Cost Total Cost Item No.

Accountability over Semi-expendable Property. Inventory Custodian Slip (ICS) shall be issued to end-
user of Semi-expendable Property to establish accountability. Accountability shall be extinguished upon
return of the item to the Asset Management Division (AMD) or in case of loss, upon approval of the
relief from property accountability.

Received from: Received by:

__________________________________
Signature Over Printed Name
__________________________________
Position/Office
__________________________________
Date
__________________________________
Signature Over Printed Name
__________________________________
Position/Office
__________________________________
Date
 Appendix 59

S No : ______________

Estimated
Useful Life

shall be issued to end-

all be extinguished upon
ss, upon approval of the
_______________
inted Name
_______________
ffice
_______________
 Appendix 60
PURCHASE REQUEST
Entity Name: _______________________ Fund Cluster: __________________
Office/Section : _____________ PR No.: ______________ Date: ____________

_________________________ Responsibility Center Code : ___________

Stock/ Property
Unit Item Description Quantity Unit Cost
No.

Purpose: ____________________________________________________________
_______________________________________________________________
_______________________________________________________________

Requested by: Approved by:

Signature : _________________________ ___________________________
Printed Name : _________________________ ___________________________
Designation : _________________________ ___________________________
 Appendix 60

_________
Date: ____________

Total Cost

_
___
___

_____________
_____________
_____________
 Appendix
PURCHASE ORDER
Supplier : _____________________________________________ P.O. No. : ____________________________
Address : _____________________________________________ Date : _______________________________
TIN : ________________________________________________ Mode of Procurement : _________________
Gentlemen:
Please furnish this Office the following articles subject to the terms and conditions contained herein:

Place of Delivery : ___________________________________ Delivery Term : ________________________

Date of Delivery : ____________________________________ Payment Term : ________________________
Stock/
Unit Description Quantity Unit Cost
Property No.

(Total Amount in Words)

In case of failure to make the full delivery within the time specified above, a penalty of one-tenth (1/10) of one percent for
every day of delay shall be imposed on the undelivered item/s.

Conforme: Very truly yours,

__________________________ ________________________________
Signature over Printed Name of Supplier Signature over Printed Name of Authorized Officia
___________________________ _____________________________
 Date Designation

Fund Cluster : ___________________________________ ORS/BURS No. : ______________________

Funds Available : _________________________________ Date of the ORS/BURS: _______________
________________________________________ Amount : ____________________________
Signature over Printed Name of Chief
Accountant/Head of Accounting Division/Unit
 Appendix 61

__________________
__________________
_________________

ontained herein:

___________________
___________________

Amount

-tenth (1/10) of one percent for

_____________________
ed Name of Authorized Official
___________________
Designation

___________________
RS: _______________
__________________
 Appendix 62
INSPECTION AND ACCEPTANCE REPORT

Entity Name : CULATINGAN ELEMENTARY SCHOOL Fund Cluster : 01-REGULAR

Supplier : KENI TANA ENTERPRISES IAR No. : _______________

PO No./Date : ___________________________________________ Date : _________________
Requisitioning Office/Dept. :Culatingan E/S Invoice No. : ____________
Responsibility Center Code : _______________________________ Date : _________________

Stock/
Description Unit Quantity
Property No.
Test Materials for Kinder copies 890
Test Materials for Grade 1 copies 1460
Test Materials for Grade 2 copies 1497
Test Materials for Grade 3 copies 1496
Test Materials for Grade 4 copies 1486
Test Materials for Grade 5 copies 1574
Test Materials for Grade 6 copies 1568

INSPECTION ACCEPTANCE
Date Inspected : March 8, 2019 Date Received : March 12, 2019

Inspected, verified and found in order as to Complete

quantity and specifications
Partial (pls. specify quantity)

MYLENE C. VILLANUEVA TERESITA G. CORTEZ

Inspection Officer/Inspection Committee Supply and/or Property Custodian
 Appendix 62
INSPECTION AND ACCEPTANCE REPORT

Entity Name : CULATINGAN ELEMENTARY SCHOOL Fund Cluster : 01-REGULAR

Supplier : KENI TANA ENTERPRISES IAR No. : _______________

PO No./Date : ___________________________________________ Date : _________________
Requisitioning Office/Dept. :Culatingan E/S Invoice No. : ____________
Responsibility Center Code : _______________________________ Date : _________________

Stock/
Description Unit Quantity
Property No.
Certificates for Printing pc 75
Graduation Tarpaulin 8x20" pc 1
Printing of Logo w/ name for Ribbons pcs 207

INSPECTION ACCEPTANCE
Date Inspected : March 8, 2019 Date Received : March 19, 2019

Inspected, verified and found in order as to Complete

quantity and specifications
Partial (pls. specify quantity)

MYLENE C. VILLANUEVA TERESITA G. CORTEZ

Inspection Officer/Inspection Committee Supply and/or Property Custodian
 Appendix 63
REQUISITION AND ISSUE SLIP

Entity Name : CULATINGAN ELEMENTARY SCHOOL Fund Cluster : 01 - REGULAR

Division : SCHOOLS DIVISION OF TARLAC PROVINCE Responsibility Center Code : ______________________

Office : ________________________________________________ RIS No. : _____________________________________
Requisition Stock Available? Issue
Stock No. Unit Description Quantity Yes No Quantity Remarks
1 packs Vellum Paper Long 20 Yes 20
2 pcs Magazine Filer 10 Yes 10
3 pcs Clear Book Long 25 Yes 25
4 reams Book Paper Long 9 Yes 9

Purpose

Requested by: Approved by: Issued by: Received by:

Signature :
Printed Name : LILIAN M. PASION TITO P. DIMALANTA TERESITA G. CORTEZ LILIAN M. PASION
Designation : DISBURSING OFFICER PRINCIPAL I PROPERTY CUSTODIAN DISBURSING OFFICER
Date :
 Appendix 63
REQUISITION AND ISSUE SLIP

Entity Name : CORAL CAMBING ELEMENTARY SCHOOL Fund Cluster : 01 - REGULAR

Division : SCHOOLS DIVISION OF TARLAC PROVINCE Responsibility Center Code : 100002000

Office : ________________________________________________ RIS No. : 2022-07-021
Requisition Stock Available? Issue
Stock No. Unit Description Quantity Yes No Quantity Remarks
1 PCS CERTIFICATE 129 / NOT AVAILABLE
2 PCS TARP 5X10 2 / NOT AVAILABLE
3 PC TARP 5X8 1 / NOT AVAILABLE

Purpose

Requested by: Approved by:

Signature :
Printed Name : HAYDEE A. GABRIEL DEMETRIO P. DIMENSIL JR.
Designation : SCHOOL REG PRINCIPAL I
Date :
 Appendix 64
REPORT OF SUPPLIES AND MATERIALS ISSUED

Entity Name: CULATINGAN ELEMENTARY SCHOOL Serial No. : 2020-08-0015

Fund Cluster: 01-REGULAR Date : 8/27/2020

To be filled up by the Supply and/or Property Division/Unit To be filled up by the Accounting Division/Unit
Responsi
bility Quantity
RIS No. Stock No. Item Unit Unit Cost Amount
Center Issued
Code
1 Book paper long Reams 36 280 10,080.00
2 Book paper short Reams 34 255 8,670
3 Brown envelope short pcs 51 3.5 179
4 ballpen Pcs 24 26 624
5 correction tape Pcs 10 38 380
6 folder long pcs 102 10 1,020

Recapitulation: Recapitulation:
Stock No. Quantity Unit Cost Total Cost UACS Object Code

1 Book paper long Reams 36 280 10,080.00

2 Book paper short Reams 34 255 8,670
3 Brown envelope short pcs 51 3.5 179
4 ballpen Pcs 24 26 624
5 correction tape Pcs 10 38 380
6 folder long pcs 102 10 1,020

Signature over Printed

TERESITA
Signature G.Name
over Printed CORTEZ
of Supply __________________________
Name of Designated ________
and/or Property Custodian Accounting Staff Date
 WASTE MATERIALS REPORT

Entity Name : _______________________ Fund Cluster : _____________________

Place of Storage : ___________________________________________ Date : ________________________________
ITEMS FOR DISPOSAL
Record of Sales
Item Quantity Unit Description Official Receipt
No. Date
1
2
3
4
5
6
7
8
9
10
TOTAL
Certified Correct : Disposal Approved :
__________________________________
Signature over Printed Name of Signature over Printed Name of Head of
Supply and/or Property Custodian Agency/Entity or his/her Authorized
Representative
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 ________ Transferred without cost to __(Name of the Agency/Entity)__

Certified Correct:
Signature over Printed Name of Witness to Disposal:
Signature over Printed
Inspection Officer Name of Witness
 Appendix 65

____________________
______________________

ecord of Sales
fficial Receipt
Amount

______________________
r Printed Name of Head of
ty or his/her Authorized
epresentative
 REPORT ON THE PHYSICAL COUNT
___________________________
(Type of Inventory Item)
As at _______________________

Fund Cluster : ________________________________

For which ___(Name of Accountable Officer)_________, _ (Official Designation)___, __________(Entity Name

Unit of
Article Description Stock Number Unit Value
Measure

Certified Correct by: Approved by:

________________________________
Signature over Printed Name of
Inventory Committee Chair and
Members
 Appendix 66
HYSICAL COUNT OF INVENTORIES
_________________________
(Type of Inventory Item)
t ________________________

_______(Entity Name)______________ is accountable, having assumed such accountability on ___(Date of Assumption)___

On Hand Per Shortage/Overage

Balance Per Card Count Remarks
(Quantity) (Quantity) Quantity Value

Verified by:

_______________________________
 Signature over Printed Name of Head of Signature over Printed Name of COA
Agency/Entity or Authorized Representative Representative
 PROPERTY ACKNOWLEDGMENT RECEIPT

Entity Name : _____________________________________

Fund Cluster: ______________________________________ PAR No.: _________________

Property Date
Quantity Unit Description
Number Acquired
Received by:
_________________________________________
Signatue over Printed Name of End User
__________________________________
Position/Office
_________________________
Date
Issued by:
__________________________________________
Signatue over Printed Name of Supply and/or
Property Custodian
_______________________________
Position/Office
_________________________
Date
 Appendix 71
RECEIPT

R No.: _________________

Amount
___________________________
Printed Name of Supply and/or
operty Custodian
_____________________
Position/Office
___________________
Date
 REPORT ON THE PHYSICAL COUNT OF PROPERTY, P
________________________________
(Type of Property, Plant and Equipment)
As at ________________________________

Fund Cluster : ________________________________

For which ___(Name of Accountable Officer)__, _ (Official Designation)___, _______(Entity Name)________ is accountable, having a

QUANTITY
PROPERTY UNIT OF UNIT
ARTICLE DESCRIPTION per
NUMBER MEASURE VALUE
PROPERTY CARD

Certified Correct by: Approved by:

 Signature over Printed Name Signature over Printed Name of Head of
of Inventory Committee Chair Agency/Entity or Authorized Representati
and Members
 Appendix 73
PROPERTY, PLANT AND EQUIPMENT
_______________
nt and Equipment)
_________________

____ is accountable, having assumed such accountability on _(Date of Assumption).

QUANTITY
SHORTAGE/OVERAGE
per REMAKS
PHYSICAL COUNT Quantity Value

Verified by:

_______________________________
er Printed Name of Head of Signature over Printed Name of COA
or Authorized Representative Representative
 INVENTORY AND INSPECTION REPORT OF U
As at _________________________

Entity Name: _______________________________________

______________________________ ______________________________
(Name of Accountable Officer) (Designation)

INVENTORY
Accumulated
Date Property Unit Total Accumulated
Particulars/ Articles Qty Impairment
Acquired No. Cost Cost Depreciation
Losses

(1) (2) (3) (4) (5) (6) (7) (8)

I HEREBY request inspection and disposition, pursuant to Section 79 of PD 1445, of the property enumerated above.

Requested by: Approved by:

(Signature over Printed Name of (Signature over Printed Name of

Accountable Officer) Authorized Official)
(Designation of Accountable Officer) (Designation of Authorized Official)
 Appendix 74
TION REPORT OF UNSERVICEABLE PROPERTY
_________________________________

Fund Cluster : _____________________

______________________________
(Station)

INSPECTION and DISPOSAL

DISPOSAL RECORD OF SALES
Carrying Appraised
Remarks Others
Amount Sale Transfer Destruction Total Value OR No.
(Specify)
(9) (10) (11) (12) (13) (14) (15) (16) (17)

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

property enumerated above. every article enumerated in this report, and witnessed the disposition of the
that the disposition made thereof was, in my articles enumerated on this
judgment, the best for the public interest. report this ____day of
_____________, _____.

over Printed Name of (Signature over Printed Name of Inspection (Signature over Printed Name of
orized Official) Officer) Witness)
of Authorized Official)
 Appendix 74

_________________

RECORD OF SALES

Amount

(18)

IFY that I have

the disposition of the
umerated on this
____day of
_____, _____.

over Printed Name of

Witness)
 REPORT OF LOST, STOLEN, DAMAGED OR DESTROYED PROPERTY
Entity Name : __________________________ Fund Cluster: ______________

Department/Office : ___________________________________________ RLSDDP No. : ______________

Accountable Officer : _________________________________________ RLSDDP Date : _____________
Designation : ________________________________________________ PAR No. : _________________
Police Notified : Yes Police Station : ____________________ PAR Date : ________________
Date : ___________________________
No

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 Immediate
Signature over Printed Name of the Accountable Officer 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. _________ Notary Public
Book No. _________
Series of _________
 Appendix 75
YED PROPERTY
Cluster: ______________

DDP No. : ______________

DDP Date : _____________
No. : _________________
Date : ________________

Acquisition Cost

_____________
_____________
_____________
_____________

____________________
ted Name of the Immediate
upervisor
___________
Date

ng the above
 Appendix 76
PROPERTY TRANSFER REPORT

Entity Name : _______________________________ Fund Cluster : _____________

From Accountable Officer/Agency/Fund Cluster : __________________________ PTR No. : ______________

To Accountable Officer/Agency/Fund Cluster : ____________________________ Date : _________________

Transfer Type: (check only one)

Donation Relocate
Reassignment Others (Specify) _________________

Date Acquired Property No. Description Amount

Reason for Transfer:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

Approved by: Released/Issued by Received by:

Signature :
Printed Name
Designation :
Date :
 Appendix 76

___________

R No. : ______________
e : _________________

___________

Condition of
PPE
_________
_________
_________
_________
_________
 PROPERTY CARD

Entity Name :

Property, Plant and Equipment : Desktop Computer

Description :
Reference/ Receipt Issue/Transfer/ Disposal
Date
PAR No. Qty. Qty. Office/Officer
 Appendix 69

ARD

Fund Cluster: ______________

Property Number :

Balance
Amount Remarks
Qty.
 TABLE OF ESTIMATED USEFUL LIFE OF
PROPERTY, PLANT AND EQUIPMENT

Estimated
Property, Plant and Equipment Useful Life
(in years)
* Land Improvements
* Land Improvements 10
* Runways / Taxiways 20
* Railways 40
* Electrification, Power and 10
Energy Structures

* Buildings - those that are predominantly

* Wood 10
* Mixed 20
* Concrete 30
* Leasehold Improvements (Note 1)
* Land 10
* Building
* Wood 10
* Mixed 20
* Concrete 30
* Office Equipment, Furnitures and
Fixtures
* Office Equipment 5
* Furniture and Fixtures 10
* IT Equipment - Hardware 5
* Library Books 5

* Machineries and Equipment

* Machineries 10
 * Agricultural, Fishery and 10
Forestry 10
* Airport Equipment 10
* Communication Equipt. 10
* Construction and Heavy 10
Equipment
* Firefighting Equipment and 7
Accessories
* Hospital Equipment 10
* Medical, Dental and Lab. 10
Equipment
* Military and Police Equipt. 10
* Sports Equipment 10
* Technical, Plant and Equipt. 10
* Other Machineries Equipt. 10
* Tranportation Equipment
* Motor Vehicles 7
* Trains 10
* Aircraft and Aircraft Ground 10
Equipment
* Watercrafts 10
* Other Transportation Equipt. 10
* Other Property, Plant and Equipt. 5
 INVENTORY/LIST OF UNISSUED TEXTBOOKS
District/School: _________________________________________

Item Grade/Year
Title of Textbook Quantity
No. Level
BOOKS

Reason/s