U.S. DOC Form doc-cd-52

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U.S. DOC Form doc-cd-52
FORM CD–52 LF
(REV. 11-84)
DAO 217-9
U.S. DEPARTMENT OF COMMERCE
DATE
NUMBER
REPORT OF REVIEW OF PROPERTY
PRIMARY ORGANIZATION UNIT
OFFICE OR STATION REPORTING
INSTRUCTIONS
DESCRIPTION IN DETAIL
TOTAL
UNIT
ACQUISITION
COST
TOTAL COST
OF UNITS
EXPLAIN CIRCUMSTANCES CAUSING REPORTED STATUS OF PROPERTY
CERTIFICATION — I HEREBY CERTIFY THAT THE INFORMATION GIVEN ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF.
SIGNATURE OF PROPERTY CUSTODIAN
TITLE
ESTIMATED
PRESENT
VALUE
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QUANTITY
(Each)
LOCATION
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Submit a separate report for each category: Lost, stolen, destroyed, damaged,
sacrificed or unserviceable property.
RECOMMENDATION
ALL THE AVAILABLE EVIDENCE AND TESTIMONY HAVE BEEN EXAMINED AND IT IS BELIEVED THAT
IT IS RECOMMENDED THAT
DATE
SIGNATURE OF ACCOUNTABLE OFFICER (OR OTHER
TITLE
DESIGNATED OFFICER)
FINDINGS AND RECOMMENDATION OF BOARD OF REVIEW
DATE
SIGNATURE
TITLE
DATE
SIGNATURE
TITLE
DATE
SIGNATURE
TITLE
I CONCUR IN THE ABOVE FINDINGS AND AUTHORIZE THAT ACTION BE TAKEN IN ACCORDANCE THEREWITH.
DATE
SIGNATURE OF RESPONSIBLE ADMINISTRATIVE OFFICER
TITLE
DISPOSITION OF PROPERTY
ARTICLE(S) LISTED ON REVERSE SIDE
DATE
SIGNATURE
TITLE
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