ARKANSAS DEPARTMENT OF FINANCE AND ADMINISTRATION
OFFICE OF INTERGOVERNMENTAL SERVICES
VICTIM JUSTICE AND ASSISTANCE PROGRAM
ANNUAL INVENTORY REPORT
(To be used to report all capital outlay purchased with subgrant funds)
SUBGRANT
ORGANIZATION
SUBGRANT SUBGRANT OCTOBER 1, TO September 30,
NUMBER PERIOD FROM:
LIST ALL EQUIPMENT AND OR PROPERTY PURCHASED (In whole or in part) WITH FEDERAL FUNDS
PART I: ITEMS CURRENTLY IN USE.
List in order of purchase, most recent purchases appearing first.
Date of Item Purchased Purchase Percent Paid Current Condition
Purchase Price With Federal New Good Fair Poor
Funds
1
2
3
4
5
PART II: ITEMS NO LONGER IN USE
List in order of purchase, most recent purchases appearing first.
Date of Item Purchased Date of Manner of Disposal
Purchase Disposition
1
2
3
4
5
Name and Title of Authorized Offical
Signature Authorized Official Date
REVISED: DECEMBER 2009