State of Texas

Office of the Governor

Public Safety Office

Equipment Disposition Request

This form is used to notify the Public Safety Office (PSO) when equipment purchased with federal or state grant funds is no longer needed for the original project or program and you wish to dispose of the item, or if grant-funded equipment has been lost, stolen or destroyed. If you are reporting on multiple, like, items that were acquired at the same time under the same federal (or state) award you only need to fill out one request.

If your agency has determined that the current per unit fair market value (FMV) of the equipment is less than $5,000 you do not need to complete this form and may retain, sell, or otherwise dispose of the equipment. Please ensure your equipment inventory list is updated to include the date of disposition, method of disposal (e.g. destroyed, transferred, sold, etc.) and sale price or FMV. The methods used to determine the FMV must be documented, kept on file, and made available upon request. Records should be maintained for 3 years from the date of disposal.

If your agency has determined that the current per unit fair market value (FMV) of the equipment is $5,000 or more, please complete the information below.

Additional information on management of grant-funded equipment may be found in the PSO General FAQs located on the eGrants website by clicking on "Updates" and then "Guides". For questions please contact Shelby Vaughan at: 512-463-8457 or shelby.vaughan@gov.texas.gov.

General Information

Click on the (?) buttons to see detailed instructions for each item.

Agency Name * 🛈

Federal (or State) Grant Number * 🛈

eGrants Grant Number (does not apply to HS grants awarded prior to 2015) * 🛈

Brief description of item(s). * 🛈

Serial number(s) or other identification number(s). * 🛈

Acquisition date * 🛈 +

Acquisition Cost (per unit). * 🛈

Current per unit fair market value (FMV). * 🛈

Is the agency reporting the loss, destruction, or theft of grant-funded equipment? * 🛈

Date of the incident * +

Amount of insurance proceeds *

In the space below include a description of the

1) circumstances surrounding the loss, theft or destruction.

2) how the incident was investigated and documented.

3) current safeguards in place to protect grant-funded equipment.

Comments *

What does the agency intend to do with the equipment? *

Trade in or sell with proceeds used to off-set the cost of replacement equipment

Retain and use for activities currently or previously supported by the same awarding agency

Transfer equipment to another agency (to be used for activities eligible under original grant program)

Retain and use for activities not previously supported by the same awarding agency

Sell (proceeds NOT used to off-set the cost of replacement equipment)

In the space below, provide brief but specific details about the equipment including:

1) Reason the equipment is no longer needed in the original project or program;

2) How the agency intends to dispose of the equipment;

3) For equipment that will be retained, a description of what activities it will be used for; and

4) If equipment is being traded or sold with proceeds used to off-set the cost of replacement equipment, provide a brief description of the replacement equipment and what the replacement equipment will be used for.

Comments *

In the space below describe:

1) Reason the equipment is no longer needed in the original project or program (i.e. reason for the transfer);

2) Name of the receiving agency; and

3) Brief description of what the receiving agency intends to do with the equipment.

Comments *

Note: If the transfer request is approved, the grantee and receiving entity shall develop and maintain on file a transfer agreement or Memorandum of Understanding (MOU) which outlines the responsibilities of each party. Disposing of equipment by transferring to other programs implies the item is no longer necessary within the original project or program. As a result, the PSO may not consider funding requests for similar equipment purchases from a grantee who has transferred equipment in this manner.

(i) Current FMV * 🛈

(ii) Percentage of Federal Participation * 🛈

(iii) Estimated selling and handling allowance * 🛈

(iv) Estimated Amount owed to the PSO (amount is automatically calculated when you click the 'calculate' button, DO NOT manually reduce or change the amount owed): 🛈

$0.00

Point of Contact

Submitter First and Last Name: *

Submitter Phone: *

Submitter Email Address *

Confirm Email *

By submitting this form you certify that:

1. You are authorized to coordinate disposal of equipment for your agency.
2. To the best of your knowledge, the information provided in this form and any supporting documentation is accurate and complete. *

Acknowledge