Revised January 1992
Appendix 30
MONTHLY REPORT OF SUPPLIES AND MATERIALS ISSUED
For the Month of Fund: Office to which Issued
3
MOOE Total Amount Issued
Amount Issued Semi-Expendable (8-72-600)
4
Date
RIS No.
Consumables (8-72-700)
5 6
TOTAL Prepared by: Approved by:
REQUISITION AND ISSUE SLIP Department of Education Division of Agusan del Sur
Division: District: Office: AGUSAN DEL SUR Division Office Responsible Center Code: Ris No. SAI No. Date: Date:
Requisition
Stock No. Description Qty Unit
Issuance
Unit Price Total Value
TOTAL Purpose: Requested by: Signature Name Designation Date Aprroved by: Issued By:
Received by:
Annex G-9
Remarks
Received by:
Appendix 53 Department of Education DIVISION OF AGUSAN DEL SUR Government Center, Patin-ay, Prosperidad, Agusan del Sur
INVENTORY CUSTODIAN SLIP
Office/District/School Qty. Unit Name and Description ( Serial No. if any ) ICS No. Inventory Item No. Estimated Life Years Unit Cost Amount
TOTAL Received by : Received from: CHRISTOPHERSON F. MORENO Signature Over Printed Name Division Supply Officer - Designate Position
Signature Over Printed Name
Position
Date
Date Appendix 53
STOCK CARD
Department of Education Agency Item : Receipt Date Reference Qty. Qty. Description : Issuance Office Stock No.: Re-order Point: Balance Qty.
Appendix 38
Point: No. of Days to Consume
Appendix 53 Department of Education DIVISION OF AGUSAN DEL SUR Government Center, Patin-ay, Prosperidad, Agusan del Sur
ACKNOWLEDGEMENT RECEIPT FOR EQUIPMENT
Office/District/School Qty. Unit asdasdas Name and Description ( Serial No. if any ) Date Aquired ARE No. Property No. asdasd Total TOTAL Received by : asdasdasdasd Signature Over Printed Name asdasdasdasdd Position asdasdasdasd Received from: CHRISTOPHERSON F. MORENO Signature Over Printed Name Division Supply Officer - Designate Position asdasdasdasd Date nanoree2010 -
Unit Cost
Appendix 9
PROPERTY CARD Department of Education Agency Property, Plant and Equipment: Description: Receipt Qty. Qty. Transfers/Disposal Office/Officer Balance Qty. Property Number:
Date
Reference
Note: For Property, Plant and Equipment.
INVENTORY AND INSPECTION REPORT OF UNSERVICEABLE PROPERTY
As of
(Agency)
( Name of Accountable Officer ) I N V E N T O R Y
( Designation ) I N S P E C T I O N DISPOSITION R E P O R T Appraisal Official Receipt Number (9) (10) (11) (12) (13) (14) (15) (16) Amount
Articles
Quantity
Unit Cost
Total Cost
Property No.
Date Acquired
No. of years in service (7)
Accumulated Depreciation (8)
(1)
(2)
(3)
(4)
(5)
(6)
I HEREBY request inspection, and disposition pursuant to Section 79 of PD 1445, of the Property enumerated above.
I CERTIFY that I have inspected each and every article enumerated in this report and that the I CERTIFY that I have witnessed the diposition of the article enumerated on this report this ______ day of ______________________.
disposition made thereof was, in my judgement, the best for the public interest.
Requested by :
Request for Inspection Approved by :
( Signature of Accountable Officer )
( Name and Signature ) ( Name and Signature of Inspector ) ( Name and Signature of Witness )
( Designation of Accountable Officer )
( Designation )
Republic of the Philippines Department of Education Caraga Administrative Region Division of Agusan del Sur Government Center, Patin-ay, Prosperidad
Report of Waste Materials
On Hand at DepEd Division Of Agusan del Sur Date: ____________________
Qty
Unit
Description
Unit Price
Amount
-
Record of sales O.R No.
Total
Property Custodian/District Supervisor
1st Indorsement
Division of Agusan del Sur
Respectfully forwarded to the Disposal Committee, Pursuant to the provision of executive order No. 888 dated March 18, 1983 for appropriate action.
TERESITA P. TRANQUILAN, H.D, CESE
Schools Division Superintendent
Certificate of Inspector
WE HEREBY CERTIFY THAT PROPERTY LISTED ABOVE DISPOSED AS FOLLOWS: ITEMS ITEMS ITEMS ITEMS ITEMS WITNESS TO DISPOSITION: Destroyed or burned Sold at public auction Sold at private sale Tranferred w/out cost to _____________ Continued in Service
CHRISTOPHERSON F. MORENO
ANDRESA G. ENRIQUEZ _______________________
_________________________
Division Supply Officer - Designate Administrative Officer V
2nd Indorsement
Respectfully returned to the Schools Division Superintendent, Patin-ay, Prosperidad, Agusan del Sur, hereby approving the action of the property Inspector as contained in his foregoing certificate, The proceeds for sales should be taken up as a credit to _______________________ . Signature Over Printed Name Designation
Record of sales Amount
/District Supervisor
983 for appropriate action.
on of the property Inspector as ______ .
Department of Education
DepEd, Division of Agusan del Sur
Report on Furnitures Procured by Division Office.
(Desk, Armchair, Teacher's table & chair, Science laboratory table & chair and Industrial arts table & chair) NOTE: Name of School/District: Complete Address of School: Division /Region: Date Received
This form shall be used by the recepient school in preparing the report on deliveries.
Supplier
Quantity
Item Description
Unit Cost
Total Cost
Status (Serviceable/ Uncerviceable)
Remarks
Prepared by:
Certified correct by:
Date:
DEPARTMENT OF EDUCATION PHYSICAL INVENTORY FOR PROPERTY, PLANT AND EQUIPMENT DIVISION OF AGUSAN DEL SUR
SCHOOL: DISTRICT: Estimated Date life yrs Acquired Status (serviceable | unserviceable)
Property code
Property # | ARE #
Article
Description (include serial # if available)
Qty
Unit cost
Total
Accountable officer
Remarks
Prepared by:
Certified correct by:
Date:
BUILDING INVENTORY Calendar Year_______ Name of School: Address:
Bldg. # Type of Bldg. Proof of Ownership Year Constructed
District: Region:
Date of Acceptance/ Turnover Cost Funding Source Materials Flooring Roofing Wall Condition No. of Stories No. of Rooms Usage of Rooms
TOTAL Number of Buildings:
Total Number of Rooms:
Type of Building No. Code 1 2 3 4 5 6 7 8 9 10 11 12 Type Gabaldon Magsaysay Marcos Imelda SEDIP TEEP New Con TEEP Repaired SPHERE (PFSED) RED & BLACK (PFSED) FVR WATSAN Toilet New Con Toilet Repaired DPWH DepED GAA Others: Specify
Proof of Ownership Cert. of Inspection and Acceptance 2 Certificate of turnover Deed of 3 donation 4 Others: Specify Materials Used 1 2 3 4 5 6 Steel Concrete Wood Nipa G.I Sheets Others: Specify 1 1 2 3 4 5 6 7 8 9 10 11
Usage of Room Academic Classroom Science Laboratory Practical Arts Home Economics Workshop Office Store Room Library Conference Room Clinic Others: Specify
1 2 3 4 5 6 7
Conditions Good Need Repair Need Rehab Condemnable Incomplete Under Constr'n Others: Specify
Funding Sources 1 2 3 4 5 6 7 8 9 10 11 DepED GAA LGU NGO PTCA JICA AUS AID TEEP SEDIP CDF DPWH Others: Specify
13
14 15 16
Prepared by:
Certified correct by:
Date:
