Form SF-428-A Standard Form 428, Annual Report and Instructions-A

TANGIBLE PERSONAL PROPERTY REPORT

Annual Report SF-428- A

Federal Grant or Other Identifying Number Assigned by Federal Agency (Block 2 on SF-428). Leave blank for Consolidated Annual Reports (Block 1 below)

1. Report Type (Choose One)

(a) Individual ___ (Reporting Federally-owned property for one award)

(b) Consolidated ___ (Reporting Federally-owned property for all awards with a Federal Agency Organizational Element)

2. Report As Of:

30 SEP _____ (YYYY)

or __/___/____ (MM/DD/YYY)

3. Federally-owned Property

	Description (a)	Identification (b)	Acquisition Date (c)	Acquisition Cost (d)
1
2
3
4
5
6
7
8
9
10

4. Comments

Instructions for Federally Owned Property Annual Report: SF-428 Attachment A

A. General Instructions:

This Attachment is to be used by recipients of Federal financial assistance when required to provide annual inventory listings of Federally-owned property.

Recipients shall report Federally-owned property in their custody as of the date in Block 2 of this Attachment, including Federally-owned items they have provided to their subrecipients or contractors. The report shall list all items of Federally-owned property, regardless of dollar value, furnished by the Federal awarding agency for use under an assistance award.

Federal Grant or Other Identifying Number Assigned by Federal Agency. Enter the Federal grant number or other identifying number assigned to the Federal financial assistance award. Leave blank if submitting a Consolidated Annual Report.

1. Report Type.

Select (a) Individual to report Federally-owned property for one award.

Select (b) Consolidated to report Federally-owned property for all awards with a Federal Organizational Element (Block 1 of the SF-428). For example, all Federally-owned property accountable to awards issued by NASA Glenn Research Center could be listed on one Consolidated Annual Report Attachment. All Federally-owned property accountable to awards with NASA Goddard Space Flight Center would be listed on a separate report. If this option is selected, in addition to the data in 3(a)-3(d), you must identify the applicable award numbers. You may use the Comments Section (for example, “NAG3-1234 Items 1-3; NAG3-5678 Item 4; etc.). Alternatively, you may attach a Supplemental Sheet SF-428S or computer printout with the required information.

2. Report as of. The report shall be submitted with information accurate as of 30 September, unless the award specifies a different date. Enter the appropriate month, day and year (mm/dd/yyyy).

3. Federally-owned property. Use this section to provide the specified information for each item or attach an equivalent document, such as a computer print out with the required detail. If additional space is required, you may use Supplement Sheet SF-428S.

a. Description. Provide a brief description of the item.

b. Identification. Enter the manufacturer’s serial number, model number, Federal stock number, national stock number, or other identification number.

c. Acquisition Date. For items furnished by the Federal awarding agency, enter the date received by the recipient.

d. Acquisition Cost. Enter the acquisition cost.

4. Comments. Provide any special notes or comments regarding the Federally-owned property being reported or the report itself in this block. For Consolidated Annual Report Attachments, use this section to identify the award numbers applicable to the listed items or note in this section if you are providing the required individual item information on an attached SF-428S or a computer printout.

SF- Annual Report Form – Attachment to SF-428

OMB Approval Number: