Property Report for Lost/Stolen/Cannibalized/Destroyed/Contaminated

Date*

Subcontractor Number:*

DOE tag no.*

Subcontractor tag no.

Property Description:*

Organization / Affiliation*

First Name*

Last Name*

Email*

Phone

Street

City

State

Postal Code

Property*

Property has been LOST/STOLEN:
Property has been DESTROYED, CANNIBALIZED OR CONTAMINATED:

Please complete the following search actions, and check off when completed:

Have you verified all property numbers assigned to your subcontract?
Have you questioned all employee with access to the property?
Have you searched all storage areas, offices, receiving area and other possible locations?

Please offer suggestions or conclusions on how and when the property may have been lost/stolen:

Does this loss reflects the effectiveness of your Property Management System?

yes
No

If yes, please state remedy(ies) and expected dates(s) to be implemented.

Did the item contain stored data that was classified, export controlled, business sensitive, or could be detrimental to UT-Battelle, the government, or your organization?

yes
No

Explain what effort was undertaken to recover the lost/stolen item.

Is there a police report?

Yes
No

If yes, please fax a copy to Tina J. Graves, CPPA, (865) 241-4017

Please fully explain the facts and circumstances:

Please state last known location of the property?*

I certify the above information and data provided is accurate and complete to the best of my knowledge:*

Certify

Name:*

Date*

Name

This field is for validation purposes and should be left unchanged.

Property Report for Lost/Stolen/Cannibalized/Destroyed/Contaminated

ORNL Subcontractor-Held Property Coordinator:

Property Management Staff: