INVENTORY AND INSPECTION REPORT OF UNSERVICEABLE PROPERTY

As of

(LGU) (Name of Accountable) (Designation)

INVENTORY
ARTICLES QTY UNIT TOTAL PROPERTY DATE No. of yrs. ACCUM.
COST COST NUMBER ACQUIRED in SERVICE DEPREC.

1 2 3 4 5 6 7 8 9 10

I HEREBY Request inspection and disposition

pursuant to Section 79 of
N REPORT OF UNSERVICEABLE PROPERTY

(Station)

INSPECTION REPORT
Appraisal Official
Receipt Amount
Number
11 12 13 14 15 16