Division For Rehabilitation Services - Equipment Inventory List
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1Division for Rehabilitation Services
Equipment Inventory List
See DARS3152INST for instructions on completing this form.
Grantee:
Grant Number:
1. Description of Equipment
2. Inventory
3. Serial
4. Data
5. Unit
6. DARS %
7. Current
(including Model Number)
Number
Number
Acquired
Cost
Share
Location
The information presented above represent, to the best of my knowledge, an accurate assessment of the
inventory of equipment purchased with grant funds.
Signature of Financial Administrative Authority:
Date:
X
Signature of Board Member:
Date:
X
DARS DRS Review
RPSA Signature:
Date:
X
DARS3152 (02/06) A+
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Parent category: Business