Law Enforcement Support Office (LESO) 

Instructions for completing the DD Form 200, Financial Liability Investigation of Property Loss (FLIPL)

DD Form 200 Page 1 

The LESO will only accept the JUL 2009 Version

Block 1: Enter form completion start date (ex., 20221031).

Block 2: Leave blank, LESO HQ use only.

Block 3: Enter applicable circumstance date (ex., 20221031).

Block 4: Enter applicable National Stock Number (NSN) or local stock number (LSN) for assigned property number in the Federal Excess Property Management 

Information System (FEPMIS).

Block 5: Enter FEPMIS property name (nomenclature), property number and the serial number (if recorded/known). Note: If there is more than one (1) property 

number with the same circumstance, please select the "Add More Items" action button to add a continuation page and enter the additional property numbers there.

Block 6: Enter quantity value assigned to Federal Excess Property Management Information System (FEPMIS) property number.

Block 7: Enter property number unit of issue cost value as recorded in FEPMIS.

Block 8: Enter product value of blocks 6 & 7 (ex., 3 x $333 = $999)

Block 9: Enter a statement that summarizes the property circumstances:

1) Who (Applicable agency/POCs involved)

2) What (Identify the property)

3) Where (Location where circumstance occured)

4) When (Date of circumstance)

5) Why (What actions lead up to the circumstance and why did it happen?)

6) How was the property: (Select from below options)

• Lost: No documented chain of custody (Just can't find), an incident report and proof of item & serial (if known) entry to NCIC and applicable statements 

should accompany the DD200 (Enter "X" in lost box)

• Disposed: Improper disposal of assigned property vice turning back into DLA Disposition Services (DS) Field Site, may require agency memorandum for 

record (MFR), (Enter "X" in Organization box)

• Destroyed: Property original state total loss by fire, natural disaster, etc., and cannot be turned back in to DLA DS, may require photograph of 

circumstance and agency memorandum for record (MFR) (Enter "X" in Destroyed box)

• Consumed: Property was used as intended (ex., medical supplies) and generally does not require additional documentation (Enter "X" in Organization

box)

• Installed: Authorized service part installed on another end item (ex., armored vehicle property number 12345MI00001) without replacement, cannot be

used to enhance or modify end item (Enter "X" in Installation box)

• Other: Circumstance not defined above (ex., property lost by commercial carrier), LESO HQ can provide guidance to the State for documenting this

circumstance (Enter "X" in Organization box)

Block 10: Enter statement to mitigate future loss circumstance (if applicable)

Block 11(a): Enter agency physical address as listed on current LESO Application for Participation Package.

Block 11(b-e): Respective fields shall be completed by CLEO (or designee) as listed on current LESO Application for Participation Package.

Block 12(a-g): Respective fields shall be completed by the LESO State Coordinator/State Point of Contact (SPOC).

Blocks 13 & 14(a-h): Reserved for LESO HQ use only

Instructions continued to next page
 

Law Enforcement Support Office (LESO) 

Instructions for completing the DD Form 200, Financial Liability Investigation of Property Loss (FLIPL)

DD Form 200 Page 2

DD Form 200 Page 3 - Continuation of Blocks 4-8

Note- Denote the number of pages in top right of form (ex. Page 2 of 2 Pages).

Block 1: Enter date from Block 1, page 1 (ex., 20221031).

Block 2: Leave blank, LESO HQ use only.

Note- Denote Item Number value (ex., 2, 3, 4, etc.,) for additional NSN in far left column under Block 1.

Block 4: Enter applicable National Stock Number (NSN) or local stock number (LSN) for assigned property number in the Federal Excess Property Management 

Information System (FEPMIS).

Block 5: Enter FEPMIS property name (nomenclature), property number and the serial number (if recorded/known). Note: If an additional continuation page is 

needed, select the "New Page" action button in lower left-hand corner of form and follow steps as outlined on this page.

Block 6: Enter quantity value assigned to Federal Excess Property Management Information System (FEPMIS) property number.

Block 7: Enter property number unit of issue cost value as recorded in FEPMIS.

Block 8: Enter product value of blocks 6 & 7 (ex., 3 x $333 = $999).

Note- In lower right of form, verify subtotal values of continuation page(s) are populated and grand total is populated (if last page).

**Important** Please email the completed DD Form 200 to lesocertifications@dla.mil and please remember to submit the Change of Status (COS) in FEPMIS.

THIS PAGE IS NOT USED

End of Instructions
FINANCIAL LIABILITY INVESTIGATION OF PROPERTY LOSS

1. DATE INITIATED (YYYYMMDD) 3. DATE LOSS DISCOVERED

(YYYYMMDD)

2. INQUIRY/INVESTIGATION NUMBER

4. NATIONAL STOCK NO. 5. ITEM DESCRIPTION 6. QUANTITY 7. UNIT COST 8. TOTAL COST

9. CIRCUMSTANCES UNDER WHICH PROPERTY WAS (X one)

(Attach additional pages as necessary)

10. ACTIONS TAKEN TO CORRECT CIRCUMSTANCES REPORTED IN BLOCK 9 AND PREVENT FUTURE OCCURRENCES (Attach additional

pages as necessary)

Lost

Organization Installation OCIE

Damaged Destroyed

11. INDIVIDUAL COMPLETING BLOCKS 1 THROUGH 10

13. APPOINTING AUTHORITY

d. ORGANIZATIONAL ADDRESS (Unit Designation,

Office Symbol, Base, State/Country, ZIP Code)

c. LEGAL REVIEW

COMPLETED IF

REQUIRED (X one)

a. RECOMMENDATION b. COMMENTS/RATIONALE

(X one)

14. APPROVING AUTHORITY

12. (X one)

a. ORGANIZATIONAL ADDRESS (Unit Designation,

Office Symbol, Base, State/Country, ZIP Code)

g. DATE SIGNED

c. ORGANIZATIONAL ADDRESS (Unit Designation, d. TYPED NAME (Last, First, Middle Initial) e. DSN NUMBER

Office Symbol, Base, State/Country, ZIP Code)

g. SIGNATURE

g. SIGNATURE

h. DATE SIGNED

e. TYPED NAME (Last, First, Middle Initial) f. DSN NUMBER

h. DATE SIGNED

e. TYPED NAME (Last, First, Middle Initial) f. DSN NUMBER

d. ORGANIZATIONAL ADDRESS (Unit Designation,

Office Symbol, Base, State/Country, ZIP Code)

b. TYPED NAME (Last, First, Middle Initial)

d. SIGNATURE

f. SIGNATURE

c. DSN NUMBER

e. DATE SIGNED

RESPONSIBLE OFFICER (PROPERTY RECORD ITEMS REVIEWING AUTHORITY (SUPPLY SYSTEM STOCKS)

a. NEGLIGENCE OR

ABUSE EVIDENT/

SUSPECTED (X one)

b. COMMENTS/RECOMMENDATIONS

a. RECOMMENDATION b. COMMENTS/RATIONALE

(X one)

c. FINANCIAL LIABILITY

OFFICER APPOINTED

(X one)

YES

YES NO

NO

APPROVE

DISAPPROVE

APPROVE

DISAPPROVE

DD FORM 200, JUL 2009 PREVIOUS EDITION IS OBSOLETE. Adobe Designer 8.0

YES NO N/A

Page 1
15. FINANCIAL LIABILITY OFFICER

a. FINDINGS AND RECOMMENDATIONS (Attach additional pages as necessary)

a. DOCUMENT NUMBER(S) USED TO ADJUST PROPERTY RECORD

a. I HAVE EXAMINED THE FINDINGS AND RECOMMENDATIONS OF THE FINANCIAL LIABILITY OFFICER AND (X one)

b. I HAVE BEEN INFORMED OF MY RIGHT TO LEGAL ADVICE. MY SIGNATURE IS NOT AN ADMISSION OF LIABILITY.

b. DOLLAR AMOUNT OF LOSS c. MONTHLY BASIC PAY d. RECOMMENDED FINANCIAL LIABILITY

g. DSN NUMBER

d. DSN NUMBER

e. DSN NUMBER

f. TYPED NAME (Last, First, Middle Initial)

h. DATE SUBMITTED TO APPOINTING

AUTHORITY (YYYYMMDD)

i. DATE APPOINTED

(YYYYMMDD)

e. ORGANIZATIONAL ADDRESS (Unit Designation,

Office Symbol, Base, State/Country, ZIP Code)

c. ORGANIZATIONAL ADDRESS (Unit Designation, d. TYPED NAME (Last, First, Middle Initial)

Office Symbol, Base, State/Country, ZIP Code)

b. ORGANIZATIONAL ADDRESS (Unit Designation, c. TYPED NAME (Last, First, Middle Initial)

Office Symbol, Base, State/Country, ZIP Code)

j. SIGNATURE k. DATE SIGNED

f. SIGNATURE g. DATE SIGNED

e. SIGNATURE f. DATE SIGNED

16. INDIVIDUAL CHARGED

17. ACCOUNTABLE OFFICER

Submit the attached statement of objection. Do not intend to make such a statement.

DD FORM 200 (BACK), JUL 2009

THIS PAGE IS NOT USED

Page 2
1. DATE INITIATED (YYYYMMDD) 2. INQUIRY/INVESTIGATION NUMBER

CONTINUATION OF BLOCKS 4 - 8

8. 

TOTAL COST

7. 

UNIT COST

6. 

QUANTITY

ITEM 

NO.

5. 

ITEM DESCRIPTION

4. NATIONAL STOCK NO.

LINE ITEM NO.

Page of Pages

FOR INTERMITTENT PAGES, ENTER SUBTOTAL:

IF LAST PAGE, ENTER GRAND TOTAL:

DD FORM 200, JUL 2009

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