WASTE MATERIALS REPORT

Entity Name: COURT OF TAX APPEALS Fund Cluster:

Place of Storage: Property and Supply Division

ITEMS FOR DISPOSAL

ITEM QTY. UNIT DESCRIPTIONRECORD OF SALES

Official ReceiptNo. Date

1 pc. 2 UPS Battery***Nothing follows***

Part of: 11-CTA-198 (Networking)

TOTALCertified Correct: Disposal Approved:

ROMMEL A. LANDICHOProperty Officer Signature over Printed Name of Head

Agency/Entity or his/her Authorized

Representative

CERTIFICATE OF INSPECTION

I hereby certify that the property enumerated above was disposed of as follows:

Item DestroyedItem Sold at private saleItem Sold at public auctionItem Transferred without cost to ___________

Certified Correct: Witness to Disposal:

Signature over Printed Name of Signature over Printed Name of

Date: 2/16/2015

Inspection Officer Witness

WASTE MATERIALS REPORTNo. 15

01

ITEMS FOR DISPOSALRECORD OF SALES

Official ReceiptAmount

Disposal Approved:

CERTIFICATE OF INSPECTION

I hereby certify that the property enumerated above was disposed of as follows:

Witness to Disposal:

Date: 2/16/2015

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