Appendix 65

WASTE MATERIALS REPORT

Entity Name : BALANI-PARONGKING ELE Fund Cluster : _____________________

Place of Storage : ___________________________________________ Date : ________________________________

ITEMS FOR DISPOSAL

Record of Sales
Item Quantity Unit Description Official Receipt
No. Date Amount
Grade IV 13 pcs Science for Daily Use 4
7 pcs Mathematics for A Better Life
5 pcs Hiyas sa Wika 4
8 pcs Hiyas sa Pagbasa
2 pcs Diwang Makabansa

TOTAL
Certified Correct : Disposal Approved :
RICARDO P. DION MERCEDES F. CALAUNAN
Signature over Printed Name of Supply Signature over Printed Name of Head of
and/or Property Custodian Agency/Entity or his/her Authorized
Representative

CERTIFICATE OF INSPECTION

I hereby certify that the property enumerated above was disposed of as follows:

Item ________ Destroyed

Item ________ Sold at private sale
Item ________ Sold at public auction
Item ________ Transferred without cost to __(Name of the Agency/Entity)__

Certified Correct: Witness to Disposal:

Signature over Printed Name of Signature over Printed Name of

Inspection Officer Witness

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