Form Ad-107 - Report Of Transfer Or Other Disposition Or Construction Of Property

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Report No.
United States Department of Agriculture
Report of Transfer or Other Disposition or Construction of Property
Date
1. Type of Transaction (Report each type separately)
2. Authorization Reference
3. Proceeds Received
Transfer
Sale
Trade In
Donation
Construction
Rehab
As-Is
$
4. Reporting Agency
5. Receiving Agency (Or Name of Purchaser or Donee):
A. Organizational Unit
A. Organizational Unit (Or Address of Purchaser)
B. Location
B. Location
C. Signature
C. Signature
D. Title
D. Title
E. Date
6. Property Items
Quantity
Item Description
Inventory
(Or Prop. No.)
(Give Full Details Including Serial Numbers, If Any, and Condition Code)
Value
Certifications of Property and Fiscal Officers
7. Property Officer: This transaction is completed and the necessary entries
8. Fiscal Officer
have been made to adjust the property records proceeds, if any, are to be
A.
The sum indicated below has been received in payment for the property
disposed of.
deposited to:
B.
The necessary entries have been made to adjust the accounting records.
Amount ($)
Schedule No.
Signature
Date
Signature
Date
This form was electronically produced by National Production Services Staff
Form AD-107 (11/89)
Clear Form

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