Form 1424 Inventory Disposal Report

OMB Control Number: 9000-0075
Expiration Date: 10/31/2015

INVENTORY DISPOSAL REPORT
(See FAR 45.605)

Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork
Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number. The
OMB control number for this collection is 9000-0075. We estimate that it will take 15 minutes to read the instructions, gather the facts, and answer the questions.
Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: U.S.
General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street, NW, Washington, DC 20405.
PLANT CLEARANCE CASE NUMBER
TO: (Include ZIP Code)

1. DATE PLANT CLEARANCE CASE OPENED

FROM: (Include ZIP Code)

2. DATE PLANT CLEARANCE CASE CLOSED

4. NAME AND ADDRESS OF CONTRACTOR/SUBCONTRACTOR (Include ZIP Code)

6. LOCATION OF PROPERTY (City and State)

11.
12.
13.
14.
15.
16.

3. NUMBER OF DAYS BETWEEN OPENING AND CLOSING

5. IF SUBCONTRACTOR, STATE NAME AND ADDRESS OF PRIME CONTRACTOR
(Include ZIP Code)

7. CONTRACT NUMBER

8. DOCKET NUMBER (Termination only)

9. SUBCONTRACT NUMBER

10. CONTRACTOR REFERENCE NUMBER

ITEM DESCRIPTION
TOTAL INVENTORY AS SUBMITTED
ADJUSTMENTS (Pricing errors, shortages, etc.)
ADJUSTED INVENTORY (Line 11 + or - Line 12)
PURCHASE OR RETENTION AT COST
RETURN TO SUPPLIERS (Net Proceeds)
REDISTRIBUTIONS
A. WITHIN OWNING AGENCY
B. OTHER AGENCIES
TOTAL

DISPOSITION OF PROPERTY
LINE ITEMS

ACQUISITION COST

PROCEEDS

17. DONATIONS
18. SALES
19. SALES - SCRAP PROCEEDS TO OVERHEAD
20.
21.
22. TOTAL PROCEEDS CREDIT (Total Lines 14, 15, and 18)
23.
24.
25.
26.

ABANDONED
DESTROYED/ABANDONED
DESTROYED/SCRAPPED
OTHER (Explain in Item 28, Remarks)

27. TOTAL DISPOSITIONS
28. REMARKS (Identify contract number in which proceeds were applied, or disbursing office where proceeds were deposited)

To the best of my knowledge, disposition of all property on this case has been effected in accordance with existing regulations, all property has been accounted
for and all disposal credits properly applied.
CONTRACT ADMINISTRATION OFFICE (Authorized signature and title)

AUTHORIZED FOR LOCAL REPRODUCTION
Previous edition is not usable

DATE

STANDARD FORM 1424 (REV. 5/2015)
Prescribed by GSA - FAR (48 CFR) 53.245(d)