Spreadsheet: 0046dd2a-0195-4838-a26e-1496cd5cc6c4
Sheet: Sheet1

Unnamed: 0 | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | DEPARTMENT OF HEALTH AND HUMAN SERVICES | Unnamed: 8 | Unnamed: 9 | Unnamed: 10 | Unnamed: 11 | Unnamed: 12 | Unnamed: 13 | Unnamed: 14 | Unnamed: 15 | Unnamed: 16 | Unnamed: 17 | Unnamed: 18 | Unnamed: 19 | Unnamed: 20 | Unnamed: 21 | Unnamed: 22 | Unnamed: 23 | Unnamed: 24 | Unnamed: 25 | Unnamed: 26 | Unnamed: 27 | Unnamed: 28 | Unnamed: 29 | Unnamed: 30 | Unnamed: 31 | Unnamed: 32 | Unnamed: 33 | Unnamed: 34 | Unnamed: 35 | Unnamed: 36 | Unnamed: 37 | Unnamed: 38 | Unnamed: 39 | Unnamed: 40 | Unnamed: 41 | Unnamed: 42
 |  |  |  |  |  |  |  |  | FIXED ASSET INPUT FORM
COMPANY |  |  |  |  |  |  | ASSET NUMBER |  |  |  |  |  |  |  |  |  |  |  |  | FUNCTION
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | A= ADD, C=CHANGE
 | ACQUISITION |  |  |  |  |  | NEW OR |  |  |  |  | PERSONAL |  |  |  |  |  |  | ACQUISITION |  |  |  |  | STATUS |  |  |  |  | CONDITION |  |  |  | OWN
 | DATE |  |  |  |  |  | USED |  |  |  |  |  |  | OR REAL |  |  |  |  | CODE |  |  |  |  | CODE |  |  |  |  | CODE |  |  |  | CODE
 | SEE ACQ DATE |  |  |  |  |  | SEE [NAME] FOR CODES
 | ASSET DESCRIPTION: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | DESCR. CODE |  |  |  |  |  | QUANTITY
 |  |  |  |  |  |  |  | FUND |  |  |  | RCC |  |  | PROGRAM |  |  |  |  | Not pd on PO Enter Direct Pay |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | *See Below
 | BUDGET CODE |  |  |  |  |  | CENTER |  |  |  |  |  |  |  |  |  |  |  |  |  | PURCHASE ORDER NO. |  |  |  |  |  |  |  |  |  | CHECK/REFERENCE NO. |  |  |  |  |  |  |  |  |  |  | NCAS OBJECT
 | BOOK
 | TYPE |  |  |  |  |  |  | COST |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | * NCAS OBJECT
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | INCLUDING SALES TAX, SHIPPING, |  |  |  |  |  |  |  |  |  |  |  | IF LAND,BLDG, OR OTHER STRUCTURE: USE FOUR DIGITS
 |  |  |  |  |  |  |  | Millions |  |  | Thousands |  |  | Hundreds |  |  | Cents |  |  | & SET UP CHARGES |  |  |  |  |  |  |  |  |  |  |  | OF BALANCE SHEET ACCOUNT. EX. 7000, 7100, ETC…
 | 3 = Cost $5,000 & Greater |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | IF EQUIPMENT USE EXPENSE ACCOUNT DROPPING THE 53.
 | 4 = Cost $ 500 to $ 4,999 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | EX. 4511, 4521, 4522, ETC…
 | MANUFACTURER/COUNTY |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | MODEL/STATE PROP. NO. |  |  |  |  |  |  |  |  |  |  |  | SERIAL NUMBER
 |  |  |  |  |  |  |  |  |  |  |  |  |  | PREPARED BY: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | DATE: |  |  |  |  | / |  | /
 | [NAME]
 | LEGEND:
 | NEW OR USED |  |  |  |  |  |  | PERSONAL OR REAL |  |  |  |  |  |  | ACQUISITION CODE |  |  |  |  |  |  |  | STATUS CODE |  |  |  |  |  |  |  | INVOICE NO.
 | N = NEW |  |  |  |  |  |  | P = PERSONAL |  |  |  |  |  |  | P = PURCHASED |  |  |  |  |  |  |  | U = IN USE
 | U = USED |  |  |  |  |  |  | R = REAL (Land,Bldg.) |  |  |  |  |  |  | C = CONSTRUCTED |  |  |  |  |  |  |  | S = AT SURPLUS |  |  |  |  |  |  |  | VENDOR NO.
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | D = DONATED |  |  |  |  |  |  |  | M = MISSING
 | CONDITION CODE |  |  |  |  |  |  | OWN CODE |  |  |  |  |  |  | I  = INVENTORY DONATED |  |  |  |  |  |  |  | R = IN REPAIR
 | BLANK |  |  |  |  |  |  | BLANK |  |  |  |  |  |  |  |  |  |  |  |  |  |  | I   = IDLE |  |  |  |  |  |  |  | CONTROL GROUP  DATE |  |  |  |  |  |  |  |  |  |  | BATCH NO.
 | G = GOOD |  |  |  |  |  |  | F = FEDERAL |  |  |  |  |  |  |  |  |  |  |  |  |  |  | N = ON LOAN |  |  |  |  |  |  |  |  |  | / |  | /
 | P = POOR |  |  |  |  |  |  | W = WIC