TANGIBLE PERSONAL PROPERTY REPORT

SF- 428

OMB Number: 4040-0018

Expiration Date: 6/30/2020

1. Federal Agency and Organizational Element to Which Report is Submitted

3a. DUNS

Recipient Organization Name:

Street1:

Street2:

City:

State:

Country: ZIP / Postal Code:

County:

Province:

2. Federal Grant or Other Identifying Number Assigned by

Federal Agency

4. Recipient Organization (Name and complete address including zip code)

3b. EIN

5. Recipient Account or Identifying Number 6. Attachment (Check applicable)

Disposition Report/Request (SF-428-C)

Final (Award Closeout) Report (SF-428-B)

Annual Report (SF-428-A)

7. Supplemental Sheet

Yes

No

8. Comments

9a. Typed or Printed Name and Title of Authorized Certifying Official

Prefix: First Name: Middle Name:

Last Name: Suffix:

Title:

9b. Signature of Authorized Certifying Official 9c. Telephone (area code, number, extension) 9d. E-Mail Address 9e. Date report submitted (MM/DD/YYYY) 10. Agency use only
Instructions for Tangible Personal Property Report: SF-428

The estimated annual public reporting burden for the collection of information on this form and its attachments is estimated to average 1 hour per

respondent, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and

reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including

suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (4040-0018), Washington, DC 20503.

This is a standard form to be used by awarding agencies to collect information related to tangible personal property (equipment and

supplies) when required by a Federal financial assistance award. The form consists of the cover sheet (SF-428) and three attachments

to be used as required: Annual Report, SF428-A; Final (Award Closeout) Report, SF-428-B; and a Disposition Request/Report,

SF-428-C. A Supplemental Sheet, SF-428S, may be used to provide detailed individual item information.

2

A. General Instructions:

Tangible personal property means property of any kind, except real property, that has physical existence. It includes equipment and

supplies. It does not include copyrights, patents or securities. For convenience, throughout this form and its attachments, the term

property will be synonymous with tangible personal property. The terms equipment and supplies will be used when referring to specific

requirements.

Property may be provided by the awarding agency or acquired by the recipient with award funds. Federally-owned property consists of

items that were furnished by the Federal government.

Recipients of Federal assistance awards may be required to provide Federal awarding agencies with information concerning property in

their custody annually, at award closeout or when the property is no longer needed. Specific requirements will vary based on award

provisions, the type of property (equipment or supplies) and whether the property is Federally-owned. This reporting form and its

attachments are intended to assist recipients to provide necessary information when it is required.

1. Federal Agency and Organizational Element to Which Report is Submitted. Enter the name of the Federal agency and the

agency organization element identified in the award document or as otherwise instructed by the agency. The organizational element is

a sub-agency within a Federal agency. For example, the Air Force Office of Scientific Research (AFOSR) is an organizational element

within the Department of Defense.

2. Federal Grant or Other Identifying Number Assigned by Federal Agency. Enter the Federal grant, cooperative agreement or

other Federal financial assistance award instrument number or other identifying number assigned to the Federal financial assistance

award.

3a. DUNS. Enter the recipient organization’s Data Universal Numbering System (DUNS) number or Central Contract Registry

extended DUNS number. The DUNS number is also referred to as the Universal Identifier.

3b. EIN. Enter the recipient organization’s Employer Identification Number (EIN) as assigned by the Internal Revenue Service.

4. Recipient Organization. Enter the name and complete address, including zip code, of the recipient organization.

5. Recipient Account or Identifying Number. Enter the account number or other identifying number assigned to the award by the

recipient. This number is for the recipient’s use and is not required by the Federal agency.

6. Attachment. Check the applicable line to indicate the type of attachment being submitted. Use the Annual Report, SF-428-A, when

required to provide annual inventory listings of Federally-owned property. Use the Final Report, SF-428-B, when required to provide

property information in connection with the closeout of an award. Use the Disposition Request/Report, SF-428-C, when required to

request disposition instructions for or to report the disposal of Federally-owned property or acquired equipment, at any time other than

award closeout (i.e., during the award period or after award closeout as long as the Federal government retains an interest in the item).

7. Supplemental Sheet. Check the applicable block to indicate whether a Supplemental Sheet is attached. Recipients may use the

SF-428S or equivalent document such as a computer print out to provide required detailed individual item information.

8. Comments. Provide any explanations or additional information in this block. Attach additional sheets if necessary.

10. Agency use only. This section is reserved for Federal agency use only.

e. Date report submitted. Enter the date the report is submitted to the Federal agency.

d. E-Mail Address. Enter the e-mail address of the individual listed in 9a.

c. Telephone. Enter the telephone number of the individual listed in Line 9a.

b. Signature of Authorized Certifying Official. Original signature of the recipient’s authorized certifying official.

9a. Typed or Printed Name and Title of Authorized Certifying Official. Enter the full name and title of the recipient representative

authorized to sign this report.