Appendix 58

STOCK CARD
Entity Name: ___________________________________ Fund Cluster: _________________

Item : Stock No. :

Description : Re-order Point :

Unit of Measurement :
Receipt Issue Balance No. of Days to
Date Reference Consume
Qty. Qty. Office Qty.
 Appendix 59

INVENTORY CUSTODIAN SLIP

Entity Name: _________________________________

Fund Cluster : ________________________________ ICS No : ______________

Amount
Inventory Estimated
Quantity Unit Description
Unit Cost Total Cost Item No. Useful Life
2 pc 124.00 248.00 Saw
5 pc 130.00 650.00 small fruit crate black
5 m 21.00 105.00 wiremax flat cord 16/2
10 pc 10.00 100.00 flower pot
3 pc 31.00 93.00 sewing kit
1 pc 47.00 47.00 mirror
1 pc 15.00 15.00 paper tape
1 pc 27.00 27.00 paper tape
1 pc 44.00 44.00 packing tape
2 pc 87.00 174.00 cannon hammer
1 pc 26.00 26.00 screw driver
1 pc 26.00 26.00 knife
1 pc 28.00 28.00 pencil
1 pc 40.00 40.00 NSG-AV wire
1 pc 16.00 16.00 blackboard eraser
1 pc 40.00 40.00 meter (fish eye)
1 pc 62.00 62.00 metal saw
1 botle 22.00 22.00 rugby
1 pc 1000.00 1000.00 portable sewing machine
1 pc 3499.00 3499.00 Electric Circular Saw
1 roll 499.00 499.00 Roll wood matting
1 pc 820.00 820.00 Pc marine plyboard 1/2
3 pc 176.00 528.00 Pcs KD 1x2x12
3 pc 108.00 324.00 Pcs 1/2x2x12
1 pc 100.00 100.00 Halfele 12 (door catches)
1/2 kilo 40.00 40.00 Kilo nail 1”
1/2 kilo 40.00 40.00 Kilo nail 2”
3 pc 40.00 120.00 Pcs handle
1 pair 120.00 120.00 Pair piano hinges
1 pack 55.00 55.00 Pack stikwel
4 pc 20.00 80.00 Pcs sand paper
1 pc 1040.00 1040.00 3/4 plyboard
1/2 kilo 40.00 40.00 Kilo F. nail 1 ½”
Received from: Received by:

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

_________

ate: ____________

Total Cost

_
____
____

______________
______________
______________
 Appendix

PURCHASE ORDER
______________________
Entity Name

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

__________________
__________________
_________________

s contained herein:

___________________
___________________

Amount

tenth (1/10) of one percent for

_____________________
ed Name of Authorized Official
___________________
Designation

___________________
RS: _______________
__________________
 Appendix 62

INSPECTION AND ACCEPTANCE REPORT

Entity Name : __ DEP-ED CALANGITAN ELEMENTARY SCHOOL Fund Cluster : ___________

Supplier : ______________________________________________ IAR No. : _______________

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

Stock/
Description Unit Quantity
Property No.
Saw pc 2
small fruit crate black pc 5
wiremax flat cord 16/2 m 5
flower pot pc 10
sewing kit pc 3
mirror pc 1
paper tape pc 1
paper tape pc 1
packing tape pc 1
cannon hammer pc 2
screw driver pc 1
knife pc 1
pencil pc 1
NSG-AV wire pc 1
blackboard eraser pc 1
meter (fish eye) pc 1
metal saw pc 1
rugby botle 1
portable sewing machine pc 1
Electric Circular Saw pc 1
Roll wood matting roll 1
Pc marine plyboard 1/2 pc 1
Pcs KD 1x2x12 pc 3
Pcs 1/2x2x12 pc 3
Halfele 12 (door catches) pc 1
Kilo nail 1” kilo 1/2
Kilo nail 2” kilo 1/2
Pcs handle pc 3
Pair piano hinges pair 1
Pack stikwel pack 1
Pcs sand paper pc 4
3/4 plyboard pc 1
Kilo F. nail 1 ½” kilo 1/2
INSPECTION ACCEPTANCE
Date Inspected : ________________________ Date Received : _____________________

Inspected, verified and found in order as to Complete

quantity and specifications
Partial (pls. specify quantity)

ZALDY L. TOMAS
Inspection Officer/Inspection Committee

MARY JOY B. BANAG

Inspection Officer/Inspection Committee

____________________________________________ AILEEN C. BANAG

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

Entity Name : _______ CALANGITAN E.S Fund Cluster : ______________________

Division : ____TARLAC__________________ Responsibility Center Code : ______________________

Office : ________CALANGITAN ELEMENTARY SCHOOL_________________
RIS No. : _____________________________________
Requisition Stock Available? Issue
Stock No. Unit Description Quantity Yes No Quantity Remarks
PC VECO CLASSIC NOTE 1 / 16
PC GREEN BALLPEN 1 / 16

Purpose:

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

Signature :
Printed Name : AILEEN C. BANAG LORETA C. RAZON AILEEN C. BANAG AILEEN C. BANAG
Designation : TEACHER I Head Teacher III Property Custodian TEACHER I
Date :
 REPORT OF SUPPLIES AND MATERIALS ISSUED

Entity Name: ___________________________________ Serial No. : _______________

Fund Cluster: __________________________________ Date : ____________________

To be filled up by the Supply and/or Property Division/Unit To be filled up by the Account

Responsibility Quantity
RIS No. Stock No. Item Unit Unit Cost
Center Code Issued

Recapitulation: Recapitulation:
Stock No. Quantity Unit Cost Total Cost
 Posted by:
I hereby certify to the correctness of the above information.
_____________________________________________
Signature over Printed Name of Supply and/or __________________________
of Designated Accounting
Property Custodian Staff
 Appendix 64
UED

No. : _______________________
___________________________

filled up by the Accounting Division/Unit

Amount

Recapitulation:
UACS Object Code
______________
Date
 Appendix 65

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 Amount
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: Witness to Disposal:

Signature over Printed Name of Signature over Printed Name

Inspection Officer of Witness
 Appendix 66
REPORT ON THE PHYSICAL COUNT OF INVENTORIES
_________________________________
(Type of Inventory Item)
As at ________________________
Fund Cluster : ________________________________

For which ___(Name of Accountable Officer)_________, _ (Official Designation)___, __________(Entity Name)______________ is accountable, having assumed
such accountability on (Date of Assumption) .

On Hand Per Shortage/Overage

Unit of
Article Description Stock Number Unit Value Balance Per Card Count Remarks
Measure
(Quantity) (Quantity) Quantity Value

Certified Correct by: Approved by: Verified by:

Signature over Printed Name of Inventory Committee Chair Signature over Printed Name of Head of Signature over Printed Name of Head of
and Members Agency/Entity or Authorized Representative COA Representative
 Appendix 71

PROPERTY ACKNOWLEDGMENT RECEIPT

Entity Name : _____________________________________

Fund Cluster: ______________________________________ PAR No.: _________________

Property Date
Quantity Unit Description Amount
Number Acquired
pc 2 Saw 8/11/2019 248
pc 5 small fruit crate black 650
m 5 wiremax flat cord 16/2 105
pc 10 flower pot 100
pc 3 sewing kit 93
pc 1 mirror 47
pc 1 paper tape 15
pc 1 paper tape 27
pc 1 packing tape 44
pc 2 cannon hammer 174
pc 1 screw driver 26
pc 1 knife 26
pc 1 pencil 28
pc 1 NSG-AV wire 40
pc 1 blackboard eraser 16
pc 1 meter (fish eye) 40
pc 1 metal saw 62
botle 1 rugby 22
pc 1 portable sewing machine 1000
pc 1 Electric Circular Saw 3,499.00
roll 1 Roll wood matting 499
pc 1 Pc marine plyboard 1/2 820
pc 3 Pcs KD 1x2x12 528
pc 3 Pcs 1/2x2x12 324
pc 1 Halfele 12 (door catches) 100
kilo 1/2 Kilo nail 1” 40
kilo 1/2 Kilo nail 2” 40
pc 3 Pcs handle 120
pair 1 Pair piano hinges 120
pack 1 Pack stikwel 55
pc 4 Pcs sand paper 80
pc 1 3/4 plyboard 1,040.00
kilo 1/2 Kilo F. nail 1 ½” 40

Received by: Issued by:

_________________________________________
Signatue over Printed Name of End User
__________________________________
Position/Office
__________________________________________
Signatue over Printed Name of Supply and/or
Property Custodian
_______________________________
Position/Office
_________________________ _________________________
Date Date
_________
 Appendix 73
REPORT ON THE PHYSICAL COUNT OF PROPERTY, PLANT AND EQUIPMENT
________________________________
(Type of Property, Plant and Equipment)
As at ________________________________
Fund Cluster : ________________________________
For which ___(Name of Accountable Officer)__, _ (Official Designation)___, _______(Entity Name)________ is accountable, having assumed such accountability on _(Date of Assumption).

QUANTITY QUANTITY
PROPERTY UNIT OF UNIT SHORTAGE/OVERAGE
ARTICLE DESCRIPTION per per REMAKS
NUMBER MEASURE VALUE
PROPERTY CARD PHYSICAL COUNT 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
 INVENTORY AND INSPECTION REPORT
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)

181

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

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
CTION 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 that witnessed the disposition of the
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
orized Official) Officer) of Witness)
of Authorized Official)
 Appendix 74

__________________

RECORD OF SALES

Amount

(18)

TIFY that I have

the disposition of the
numerated on this
s ____day of
_____, _____.

re over Printed Name

of Witness)
 Appendix 75
REPORT OF LOST, STOLEN, DAMAGED OR DESTROYED PROPERTY

Entity Name : Fund Cluster: ______________

Department/Office : Calangitan Elementary School RLSDDP No. : 2019-01-0001_

Accountable Officer : Loreta C. Razon RLSDDP Date : 01-05-2019
Designation : Principal 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

106369001 100 pcs Galvanized Iron Sheet 8" 10,000

Circumstances:

On the 4th day of January 5 am, Initial investigation conducted by the barangay officials at the place of incident disclosed
that had a robbery that cause 100 total loss of Galvanized Iron Sheets. Incident occurred on or about 1am to 3am.

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

LORETA C. RAZON ____________ _LOIDA L. ZAMORA_____________________

Signature over Printed Name of the Accountable Officer Signature over Printed Name of the
________________ Immediate Supervisor
Date ________________
Date
Government Issued ID : __________________
ID No. : _____________________________
Date Issued : _________________________

SUBSCRIBED AND SWORN to before me this _____day of _____________, 20___affiant exhibiting the above
government issued identification card.

Doc. No. _________

Page No. _________ Notary Public
Book No. _________
Series of _________
 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

_________
_________
_________
_________
_________
 Appendix 69

PROPERTY CARD
Entity Name : _______________________________ Fund Cluster: _____________

Property, Plant and Equipment :

Property Number :
Description :
Reference/ Receipt Issue/Transfer/ Disposal Balance
Date Amount Remarks
PAR No. Qty. Qty. Office/Officer 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