Fillable Printable Property Report

Property Report

SF- 428 Tangible Pers onal Property Report

OMB Approval Number: 3090-0289

EXPIRATION DATE: 04/ 30/2013

TANGIBLE PERSONAL PROPERTY REPORT

SF- 428

Page

of Pages

1.Federal Agency and Organization Elem ent to

Which Report is Submitted

2. Federal Grant or Other Identifying

Number Assigned by Federal Agency

3a. DUNS

3b. EIN

4. Recipient Organization (Name and complete address including zip code)

5. Recipient Account or Identifying

Number

6. Attachment (Check applicable)

___ Annual Report (SF-428-A)

___ Final (Award Cl os eout) Report (SF-428-B)

___ Disposition Report/Request (SF-428-C)

7. Supplemental Sheet

___ Yes

___ No

8. Comments

9a. Typed or Printed Name and Title of Authorized Certifying

Official

9c. Telephone

(area code, number, extension)

9d. Email address

9b. Signature of authorized Certifying Official

9e. Date report submitted (Month, Day, Year)

10. Agenc y use only

Ins tructions for Tangible Personal Propert y Re por t: SF-428

The estimated annual public reporting burden for the coll ection of information on this form and its attachm ents is estimat ed to average 2.75 hours per

respondent, incl udi ng time for reviewing instruc tions, searc hi ng existing data sources, gathering and maintaini ng the dat a needed, and completing and

revie wing the c ollect i on of information. Send c omments regarding t he burden estimate or any other aspect of this collect i on of information, i nc l udi ng

suggestions for reducing this burden, to the Offic e of Management and Budget, Paperwork Reduction Project (0348-0043), Washington, DC 20503.

This is a standard form to be used by awarding agencies to collect inform ation related to tangible personal property (equipment and

supplies) when required by a Federal financial assis tance award. The form consists of the cover sheet (SF-428) and three attachments

to be used as required: Annual Report, SF428-A; Final (Award Closeout) Report, SF-428-B; and a Disposition Request/Report, SF -

428-C. A Supplemental Sheet, SF-428S, may be used to provi de detailed individual item information.

A. General Instructions:

Tangible personal property means property of any kind, except real property, that has physical existence. It includes equipment and

supplies. It does not include copyrights, patents or securities. For convenience, throughout this form and its attachments, the term

property will be synonymous with tangibl e personal property. The terms equipment and supplies will be used when referring to specific

requirements.

Property may be provided by the awarding agency or acquired by the recipient with award funds . Federally-owned property consi s ts of

items that were furnished by the Federal government.

Recipients of Federal assistanc e awards may be required to provide Federal awarding agencies with information concerning property in

their custody annually, at award closeout or when the property is no longer needed. Specific requirements will vary based on award

provisions, the type of property (equipment or supplies) and whether the property is Federally-owned. This reporting form and its

attachments are intended to ass ist recipi ents to provide necessary information when it is required.

1. Federal Agency and Organizational Element to Which Report is Submitted. Enter the name of the Federal agency and the

agency organization element identified in the award document or as otherwise instructed by the agency. The organizational element is

a sub-agency within a Federal agency. For example, the Air Force Office of Scientific Research (AFOSR) is an organizational element

within the Department of Defense.

2. Federal Grant or Other Identifying Number Assigned by Federal Agency. Enter the Federal grant, cooperative agreement or

other Federal financial assistance award instrument number or other identifying number assigned to the Federal financial assistance

award.

3a. DUNS. Enter the reci pient organi zation’s Data Universal Numbering System (DUNS) number or Central Contract Registry

extended DUNS number. The DUNS number is also referred to as the Universal Identi fier.

3b. EIN. Enter the recipient organization’s Employer Identification Number (EIN) as assi gned by the Internal Revenue Service.

4. Recipient Organization. Enter the name and complete address, including zip code, of the recipient organization.

5. Recipient Account or Identifying Number. Enter the account number or other identifying number assigned to the award by the

recipient. This number is for the recipient’s use and is not required by the Federal agency.

6. Attachment. Check the applicable line to indicate the type of attachment bei ng submitted. Use the Annual Report, SF-428-A, when

required to provide annual inventory listings of Federally-owned property. Use the Final Report, SF-428-B, when required to provide

property information in connection with the closeout of an award. Use the Disposition Request/Report, SF-428-C, when required to

req uest dispos ition instructions for or to report the disposal of Federally-owned property or acquired equipment, at any time other than

award closeout (i.e., during the award period or after award closeout as long as the Federal government retains an interest in the item).

7. Supplemental Sheet. Check the applic able block to indicate whether a Supplemental Sheet is attached. Recipients may use the SF-

428S or equivalent docum ent such as a computer print out to provide required detailed individual item information.

8. Comm ents. Provide any explanations or additional information in this bl ock. Attach additional sheets if necessary.

9a. Typed or Printed Name and Title of Authorized Certifying Official. Enter the full name and title of the recipient representative

authorized to sign this report.

b. Signa ture of Authorized Certifying Official. Original signature of the recipient’s authorized certifying official.

c. Teleph one. Enter the telephone num ber of the individual listed in Line 9a.

d. Email address. Enter the email address of the individual l isted in 9a.

e. Date report submitted. Enter the date the report is submitted to the Federal agency.

10. Agency use onl y. This section is reserved for Federal agency use only.