SF- Final Report Form – Attachment to SF-428

OMB Approval Number:

TANGIBLE PERSONAL PROPERTY REPORT

Final Report SF-428- B

1. Report (Select all that apply)

a. ___ Federally-owned Property (List on Supplemental Sheet SF-428S or recipient equivalent and complete Section 2a below.)

b. ___ Acquired Equipment with acquisition cost of $5,000 or more for which the awarding agency has reserved the right to transfer title

(List on Supplemental Sheet SF-428S or recipient equivalent and complete Section 2b below.)

c. ___ Residual Unused Supplies with total aggregate fair market value exceeding $5,000 not needed for any other Federally sponsored

programs or projects. (Complete Section 2c below)

d. ___ None of the above

2. Complete relevant section(s) For Agency Use Only

2a. Federally-owned Property

(Select one or more.)

(i) ___ Request transfer to Award ______________

(ii) ___ Request Federal Agency disposition instructions

(iii) ___ Other (Provide detail in Block 3 or attach request)

Agency response to requested disposition of Federally owned property:

(i) Recipient request approved___ denied ___

(ii) Dispose in accordance with attached instructions ___.

2b. Acquired Equipment (Select one or more.)

 (i) ___ Request unconditional transfer of title with no 

 further obligation to the Federal Government.

 (ii) ___ Request Federal Agency disposition instructions

Note: If the awarding agency does not provide disposition 

instructions within 120 days the recipient may continue to 

use the equipment for Federally supported projects or 

dispose in accordance with the applicable property 

standards.

Agency response to requested disposition of acquired equipment::

(i) Recipient request approved___ denied ___

(ii) Dispose in accordance with attached instructions ___

Authorized Awarding Agency Official

Signature: Date:

Name: Phone:

Title Email

2c. Reportable Residual Unused Supplies 

(i) __ Sale proceeds or __ Estimate of current fair market value ........................ $_____________

(ii) Percentage of Federal participation .................................................... _____________%

(iii) Federal share ......................................................................... $____________

(iv) Selling and handling allowance ........................................................ $____________

(v) Amount remitted to the Federal Government.......................................... $____________

3. Comments

FINAL REPORT ATTACHMENT TO SF-428 Agency use only

Federal Grant or Other Identifying Number Assigned by Federal Agency (Block 2 on SF-428).

14-LFPP-XX-####

✔

9/30/20XX

(555) 555-5555

Grants Management Specilist

John Doe

✔

✔

✔

We plan to continue to use the two walk-in-freezers for the purpose that they were acquired.
SF-428S Supplemental Sheet – Attachment to SF-428 OMB Approval Number:

TANGIBLE PERSONAL PROPERTY REPORT

Supplemental Sheet SF-428S

Federal Grant or Other Identifying Number Assigned by Federal Awarding Agency (Block 2 of SF-428) Attachment Type

___ Annual Report___ Final (Award Close___ Disposition Reque

Complete one row for each item:

Award Number

 (a)

GP orACQ(b)

Description of Item

(c)

Identification Number

(d)

AcqDat

(e

12345678910

14-LFPP-XX-####

✔

ACQ Walk-In-Freezer 123 123456789 9/30

ACQ Walk-In-Freezer ABC ABCDEFGH 6/30