Form 3152, Equipment Inventory List

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Documents

Effective Date: 5/2017

 

Instructions

Updated: 5/2017

 

Applicability

An Equipment Inventory List is intended to provide Texas Health and Human Services Commission (HHSC) Division for Rehabilitation Services (DRS) with a list of all equipment purchased, in whole or in part, with funds provided under the terms and conditions of a grant.

Equipment is defined as "tangible, nonexpendable personal property having a useful life of more than one year and an acquisition cost of $5,000 or more per unit."  (34 Code of Federal Regulations Part 74.2 and Part 80.3)

An organization may use its own definition provided that such definition would at least include all equipment defined therein.

 

Report Due Date

The Equipment Inventory List is due within 45 days of the end of the budget period and must be submitted as an attachment to the Final Report of Expenditures.

 

General Instructions

Include name of grantee organization and grant number for which this report has been prepared.

 

Specific Instructions

  • Provide a description of each piece of equipment purchased under the grant during the budget period.  Include all identifying characteristics, including model number, size, color, etc.
  • Enter the identification number assigned to this item by the organization.
  • Enter the manufacturer's serial number for this item.
  • Enter the acquisition date for this item. This is the date the organization "took delivery" of the item.
  • Enter the unit cost of the item listed on the invoice.
  • Indicate how much of the acquisition cost was borne by HHSC DRS (i.e., 10%, 50%, 100%).
  • Indicate the current location of the item.

 

Submission

Once the form is completed, it must be signed by the agency’s designated Financial Administration Authority and by a member of the agency's Board of Directors (preferably the chair) attesting to the completeness and accuracy of the document and submitted to the Regional Consumer Contract Specialist.