REPORT ON THE PHYSICAL COUNT OF INVENTORIES

SAMPLE _______________________________________________________
As at______________________________
Fund Cluster:_________________________________
For which __________________________,_________________________,______________________is accountable, having assumed such accountability on__________________
Stock Unit of Unit Balance Per Card On Hand Per Count Shortage/Overage
Article Description Remarks
Number Measure Value Quantity Quantity Quantity Value
sink wash 1
Plaslict Faucets 12
Classrooms( DepEd) 1 StoreyBldg.
Each Classroom contains
Plastic ARM Chairs 150
Wall Electric Fan 6
Writing Board (Black Board) 6
Door Knob 9
Ord. Bulb 6
Flourescent bulb 12
Jalousy Window
Toilet bowl/Flusher 3
Lavatory 3
Faucet 6
6 Door Hinges 18
2 Main Doors 6
Plastic Door (Toilet) 3
Printer indicate model
puncher 3
paper cutter 2
electric fans 8
smart tv 7
fab. Tent 1
fab. Stage 1
scissors
 pencil sharpener
stapler
Prepared by

____________________________________ Verified by:

Signature over Printed Name _________________________________
Signature over Printed Name
 REPORT ON THE PHYSICAL COUNT OF INVENTORIES
_______________________________________________________
As at______________________________
Fund Cluster:_________________________________
For which __________________________,_________________________,______________________is accountable, having assumed such accountability on__________________
Stock Unit of Unit Balance Per Card On Hand Per Count Shortage/Overage
Article Description Remarks
Number Measure Value Quantity Quantity Quantity Value
2 Circuit Breaker
2 Classrooms 1 StoreyBldg.
(American Chamber Foundation)
Each Classroom contains
4 Ceiling fan
1 Flourescent Bulb
2 Ord. bulb
2 2 phase switch
2 Female outlet
3 Door knob
Jalousy window
1 Toilet Lavatory
2 Faucet
1 Toilet bowl/flusher
2 Writing board
4 Fabricated Steel window Grills
4 Door Hinges
2 Main Doors (Fabricated good lumber &
Marine Plywood)
1 Plastic Door (Toilet)

Certified Correct by:

____________________________________ Approved by: Verified by:
Signature over Printed Name of _________________________________________ _________________________________
Inventory Committee Chair and Signature over Printed Name of Head of Signature over Printed Name of COA
Members Agency/ Entity or Authorized Representative Representative