Form NIH-2741 "Request to Cannibalize Personal Property"

What Is Form NIH-2741?

This is a legal form that was released by the U.S. Department of Health and Human Services - National Institutes of Health on December 1, 2013 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on December 1, 2013;
  • The latest available edition released by the U.S. Department of Health and Human Services - National Institutes of Health;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form NIH-2741 by clicking the link below or browse more documents and templates provided by the U.S. Department of Health and Human Services - National Institutes of Health.

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Download Form NIH-2741 "Request to Cannibalize Personal Property"

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DOC # (for PPB use only)
Request to Cannibalize Personal Property
PART A -- Requester
1. I request authorization to cannibalize the following personal property item.
I understand that cannibalization of property without authorization can result in personal liability. The parts removed will be
used only for official Government purposes and I agree to transfer the residual parts to the Personal Property Branch.
Decal
Description
Manufacturer
Serial No.
Acquisition Cost Acquisition Date Present Condition
Model
2. Part(s) Requested (give a full description)
Estimated Cost if Purchased New
3. JUSTIFICATION.
Include the benefit to NIH in cannibalizing this property, the intended use of the requested parts, the decal number of the
property item that will be upgraded with the cannibalized parts, etc.
4. Requester's Name
ICD or Organization
Phone No.
5. Requester's Signature
Date of Request
ICD
Custodial Code
Phone No.
Fax No.
6. RECOMMENDING OFFICIALS
(Signatures)
a. ICD Approval
Date
c. Property Management Representative
Date
b. Property Custodial Officer
Date
Forward this form to the Personal Property Branch,
Building 13, Room 2E65.
PART B -- Personal Property Branch Approval
1. PPB Equipment Specialist
Date
2. Chief, PAS
Date
Chief, Personal Property Branch
Date
3. APPROVAL:
Cannibalization is approved. After cannibalization occurs,
transfer the residual parts and the property decal to the Personal Property
Branch, Building 13, Room 2E65, using Form NIH 649, "Report of Property
Transfer." Tape a copy of the approved form to the parts shipment.
NIH 2741 (12/13)
DISTRIBUTION OF COPIES: White
- Requester
Green
- Property Management Representative
Canary
- Chief, PAS
Pink
- Equipment Specialist
Goldenrod - Audit File
DOC # (for PPB use only)
Request to Cannibalize Personal Property
PART A -- Requester
1. I request authorization to cannibalize the following personal property item.
I understand that cannibalization of property without authorization can result in personal liability. The parts removed will be
used only for official Government purposes and I agree to transfer the residual parts to the Personal Property Branch.
Decal
Description
Manufacturer
Serial No.
Acquisition Cost Acquisition Date Present Condition
Model
2. Part(s) Requested (give a full description)
Estimated Cost if Purchased New
3. JUSTIFICATION.
Include the benefit to NIH in cannibalizing this property, the intended use of the requested parts, the decal number of the
property item that will be upgraded with the cannibalized parts, etc.
4. Requester's Name
ICD or Organization
Phone No.
5. Requester's Signature
Date of Request
ICD
Custodial Code
Phone No.
Fax No.
6. RECOMMENDING OFFICIALS
(Signatures)
a. ICD Approval
Date
c. Property Management Representative
Date
b. Property Custodial Officer
Date
Forward this form to the Personal Property Branch,
Building 13, Room 2E65.
PART B -- Personal Property Branch Approval
1. PPB Equipment Specialist
Date
2. Chief, PAS
Date
Chief, Personal Property Branch
Date
3. APPROVAL:
Cannibalization is approved. After cannibalization occurs,
transfer the residual parts and the property decal to the Personal Property
Branch, Building 13, Room 2E65, using Form NIH 649, "Report of Property
Transfer." Tape a copy of the approved form to the parts shipment.
NIH 2741 (12/13)
DISTRIBUTION OF COPIES: White
- Requester
Green
- Property Management Representative
Canary
- Chief, PAS
Pink
- Equipment Specialist
Goldenrod - Audit File