Annex A.

INVENTORY TRANSFER REPORT

Entity Name: _______________________ Fund Cluster: __________

From Accountable Officer/Agency/Fund Cluster: ___________________ ITR No. : ______________
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: ________________________ ____________________ ______________________