INSTRUCTIONS FOR
TEXAS DEPARTMENT OF AGRICULTURE FOOD & NUTRITION
EDUCATION SERVICE CENTER (ESC) EQUIPMENT CHANGES AND INVENTORY
FND 122
PURPOSE
In accordance with Sec. 6(G)(f) of the current contract between the Education Service Centers (ESC) and the
Texas Department of Agriculture (TDA), an annual accounting is required of all equipment (those assets
with an estimated useful life of at least one year and a cost of at least $5,000, including all computers)
purchased with Child Nutrition Program funds. This form satisfies that requirement.
DEFINITION
Equipment refers to: (1) assets with an estimated useful life in excess of one (1) year and a cost of at least
$5,000 and (2) notebooks, laptops, and desktop computers that were purchased with Child Nutrition Program
funds.
TIMEFRAME
FND–122 should be completed and mailed to TDA any time there is a change (purchase or disposal) of ESC
equipment purchased with Child Nutrition Program funds during a given federal fiscal year.
SECTION A
1. ESC CONTACT INFORMATION

Enter the ESC region number (i.e. 1-20), address, city, state and zip code.

Enter the first name, middle initial, last name and title of the ESC contact person.

Enter the phone number and fax number for the ESC.
SECTION B
1. EQUIPMENT CHANGES FOR CURRENT FISCAL YEAR

Enter the current federal fiscal year using mm/dd/yyyy format.

If equipment has been purchased with Child Nutrition Program funds during the fiscal year indicated, check
appropriate box.

If equipment purchased with Child Nutrition Program funds has been disposed of during this fiscal year, check
appropriate box.

If no to both questions listed above, proceed to section C. If yes, continue.
2. EQUIPMENT PURCHASES

Any equipment purchased with Child Nutrition Program funds during the current fiscal year should be included in
this section.

Date Purchased - Enter the purchase date of each equipment item in a mm/dd/yyyy format. For example, a
purchase date of January 31, 2006, would be shown as "01/31/2006."

Identifying Number - Enter ESC's internal identifying number that is used to track this equipment item or is used
to conduct inventories of this equipment.

Description of Item - Enter a brief description of each individual item. For example, a computer in ESC’s
inventory might be entered as "laptop computer, manufacturer's name."
Operations, Nutrition and Education
Food and Nutrition Division
Revised 08/13/07
Instructions for
FND 122 Education Service Center (ESC) Equipment Changes and Inventory

Page 2 of 2
Purchase Price - Enter the historical cost of the item. Unless the item is donated, this will be the amount paid for
the item. In most cases, this will be the dollar amount at which the individual equipment item is carried in the
ESC's records.
3. EQUIPMENT DISPOSAL

Any equipment that was originally purchased with Child Nutrition Program funds, but has subsequently been
sold, traded-in, or otherwise disposed of during the current fiscal year should be shown on this section.

Date Disposed - Enter the date when each equipment item was disposed of in a mm/dd/yyyy format. For
example, a disposal date of January 31, 2006, would be shown as "01/31/2006."

Identifying Number - Enter ESC's internal identifying number that is used to track this equipment item or is used
to conduct inventories of this equipment.

Description of Item - Enter a brief description of each individual item. For example, a computer in ESC’s
inventory might be entered as "laptop computer, manufacturer's name."

Purchase Price - Enter the historical cost of the item. Unless the item is donated, this will be the amount paid for
the item. In most cases, this will be the dollar amount at which the individual equipment item is carried in the
ESC's records.
SECTION C
1. EQUIPMENT INVENTORY AFTER CHANGES (IF APPLICABLE)

ESC inventory for all equipment purchased with Child Nutrition Program funds should be listed in this section.
This applies to equipment currently on hand after changes (purchases or disposals) have been accounted for.

If a standard ESC inventory document will be submitted with this form instead of entering the current equipment
in this section, then the appropriate box should be checked.

The standard ESC inventory document must contain the same information as listed in this section.

Date Purchased - Enter the purchase date of each equipment item in a mm/dd/yyyy format. For example, a
purchase date of January 31, 2006, would be shown as "01/31/2006."

Identifying Number - Enter ESC's internal identifying number that is used to track this equipment item or is used
to conduct inventories of this equipment.

Description of Item - Enter a brief description of the individual item. For example, a computer in ESC’s
inventory might be entered as "laptop computer, manufacturer's name."

Purchase Price - Enter the historical cost of the item. Unless the item is donated, this will be the amount paid for
the item. In most cases, this will be the dollar amount at which the individual equipment item is carried in the
ESC's records.
SECTION D
1. CERTIFICATION STATEMENT, SIGNATURE

Name – Print the name of the person completing this form.

Date - Enter the date that this form is signed.

Signature - Affix the signature of the person completing this form.

Complete and mail this form with applicable attachments (standard ESC inventory documents) to:
Texas Department of Agriculture, Food and Nutrition Division, P.O. Box 12847, Austin, Texas 78711
Food and Nutrition Division
Revised 08/13/07