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Check One Only of  Form

Check One Only of Form

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ORDERS OR DISPOSAL INSTRUCTIONS TO Title Address and Telephone Number 12. PAGE 1 OF 1. REPORT NUMBER REPORT OF EXCESS PERSONAL PROPERTY 4. TYPE OF REPORT Check one only of a b c or d 2. DATE MAILED 3. TOTAL COST a* ORIGINAL c* PARTIAL b. CORRECTED d. TOTAL W/D Also check e and/or f if appropriate e. FROM Name and Address of Reporting Agency 8. REPORT APPROVED BY Name and Title 9. FOR FURTHER INFORMATION CONTACT Title Address and Telephone Number 10. GSA CONTROL NUMBER 13. LOCATION OF PROPERTY...
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