Date:	Numbered Property	Non-Numbered Property
SECTION 1 – Employee Information
Employee Name:	Administrative Unit:
SECTION 2 – Property Information
1.	The equipment listed below will be added to the appropriate property inventory: numbered property will be added to the numbered property inventory and the non-numbered will be added to the non-numbered property inventory.
2.	Use a different sheet for each purchase order number and for different property types (numbered and non-numbered).
3.	Unless otherwise noted, this equipment will be assigned to the individual who has signed below and submitted this report.
4.	For numbered property, the Headquarters property officer will assign the property number.
5.	For numbered property, the receiver will return a copy of this form with original signature and date certifying receipt of property tag and affixation of tag to property within five business days of receipt of the property tag(s).
Vendor:	Purchase Order Number:
Item Description	Make	Model Number	Serial Number	Cost	Acquisition Type (drop-down options)	Funding Source/Amt. General (01) Special (other) Federal (10)	Assigned Property Number (Numbered Property Only)
Remarks:
SECTION 3 – VDOF Agreement
I certify that I have received the property listed above. For numbered property, I am requesting a property tag(s) be issued.
VDOF Employee Name (Print)	VDOF Employee Signature	Date
SECTION 4 – VDOF Property Tag Attachment Agreement (Numbered Property Only)
I certify that I have received the property tag(s) for the property listed above and have affixed the property tag(s) on the property as required.
VDOF Employee Name (Print)	VDOF Employee Signature	Date