LOST, STOLEN OR MISSING EQUIPMENT FORM
(ORIGINAL VALUE $5,000 OR MORE)
Name of Organization/Department Responsible for Equipment
Banner Organization #
Date
Authorized Signature for Banner Organization #
Property Tag #
Description
Serial #
Date of Disappearance
UNC Police Report #
RETURN FORM TO GENERAL ACCOUNTING OFFICE, CAMPUS BOX 44
Questions? Contact Joe Tacoronte 351-2389
GAO Form PC-04
Revised 03/20/2013
This form is used to report equipment with an original value of $5,000 or more that has been lost,
stolen or is missing for any reason. Please provide the following information:

The name of the Organization/Department reporting the loss

The Banner Organization number

An Authorized signature for the Banner Organization

The UNC property tag number

A description of the equipment

Serial number if available

The date the property was noted missing

The UNC Police Report number. (A report must be filed with the UNC Police Department
for all instances of missing equipment.)
Forward the completed form to the General Accounting Office so inventory records can be
updated and insurance claims can be filed.