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Appendix 66

REPORT ON THE PHYSICAL COUNT OF INVENTORIES


_________________________________
(Type of Inventory Item)

As at ________________________

Fund Cluster : ________________________________

For which ___(Name of Accountable Officer )_________, _ (Official Designation )___, __________(Entity Name )______________ is accountable, having assumed such accountability on ___(Date of Assumption)___ _.

Balance Per On Hand Per Shortage/Overage


Stock Unit of Unit
Article Description Card Count Remarks
Number Measure Value
(Quantity) (Quantity) Quantity Value
163

Certified Correct by: Approved by: Verified by:


________________________________ _______________________________
Signature over Printed Name of Signature over Printed Name of Head of Signature over Printed Name of COA
Inventory Committee Chair and Agency/Entity or Authorized Representative Representative
Members