AGR-2201 (R/7/19) Page 1 of 2

Food Assistance - Annual Inventory Report Instructions for Section 1: Active Inventory A yearly inventory must be taken of all equipment, with a purchase price of $5,000 or more per unit, using Food Assistance (FA) funds (ARRA, CSFP, EFAP, TEFAP, & TMP), regardless of the percentage FA paid. Section 1 - Active Inventory includes new purchases (including information technology systems) having a useful life of more than one year, as well as past purchases. All new purchases require prior approval from FA using AGR Form 609-2204. If you are a new contractor or have a new county make sure to report any transfer of equipment. A physical inventory must be taken and reconciled with equipment records once every two years.

Note: Contractors are responsible for reporting all subcontractor inventory, as applicable. List each piece of equipment separately.

Contractor Name: Contract Number:

Contact Name: Title: Phone:

SECTION 1: ACTIVE INVENTORY Purchase

Date: Item: Description: Identification: Condition: Unit Cost:

Percent of Total Cost:

FA Funding: (list all that apply)

Physical Location: Agency Title Holder:

Month/Year Item purchased Type of equipment; brand; size; for vehicles: make, model, year Serial and/or

VIN #

G=Good, F-Fair, P=Poor,

S=Scrap/Salvage

Round to the

nearest dollar

% per FA funding type

A=ARRA, C=CSFP, E=EFAP, T=TEFAP,

M=TMP

City Agency Name

Total Cost of Items:

Email this form to your regional representative or to foodassistance@agr.wa.gov

Food Assistance PO Box 42560

Olympia WA 98504-2560 foodassistance@agr.wa.gov

mailto:foodassistance@agr.wa.gov

AGR-2201 (R/7/19) Page 2 of 2

Instructions for Section 2: Inventory Disposition A yearly inventory must be taken of all equipment, with an original purchase price of $5,000 or more per unit, using Food Assistance (FA) funds (ARRA, CSFP, EFAP, TEFAP, & TMP), regardless of the percentage FA paid. Section 2 - Inventory disposition includes only disposition of equipment actions that occurred since the last annual inventory report was submitted to FA. All disposition actions require prior approval from FA using AGR Form 609-2203. If you are a new contractor or have a new county make sure to report any transfer of equipment.

Note: Contractors are responsible for reporting all subcontractor inventory, as applicable. List each piece of equipment separately.

Contractor Name: Contract Number:

Contact Name: Title: Phone:

SECTION2: INVENTORY DISPOSITION

Disposition Date: Item: Description: Identification: Condition:

Sale Price or Value:

Percent of Total Cost:

FA Funding: (list all that

apply)

Disposition Type: Agency Title Holder:

Month/Year Item purchased Type of equipment; brand; size; for vehicles: make, model, year Serial and/or

VIN #

G=Good, F-Fair, P=Poor,

S=Scrap/Salvage

Round to the nearest dollar

% per FA funding type

S=Sold, S/S= Scrap, T=Transferred, T/I=Trade-in,

L/S=Lost/Stolen

Agency Name

Total Cost of Items:

Email this form to your regional representative or to foodassistance@agr.wa.gov

Food Assistance PO Box 42560

Olympia WA 98504-2560 foodassistance@agr.wa.gov

Food Assistance - Annual Inventory Report

A=ARRA, C=CSFP, E=EFAP, T=TEFAP,

M=TMP

mailto:foodassistance@agr.wa.gov

Total Cost of Items: Total Cost of Items_2: Contractor Name: Contract Number: Phone: Title: Contact Name: MonthYearRow1: Item purchasedRow1: Type of equipment brand size for vehicles make model yearRow1: Serial andor VIN Row1: GGood FFair PPoor SScrapSalvageRow1: Round to the nearest dollarRow1: per FA funding typeRow1: CCSFP EEFAP TTEFAP AARRARow1: CityRow1: Agency NameRow1: MonthYearRow2: Item purchasedRow2: Type of equipment brand size for vehicles make model yearRow2: Serial andor VIN Row2: GGood FFair PPoor SScrapSalvageRow2: Round to the nearest dollarRow2: per FA funding typeRow2: CCSFP EEFAP TTEFAP AARRARow2: CityRow2: Agency NameRow2: MonthYearRow3: Item purchasedRow3: Type of equipment brand size for vehicles make model yearRow3: Serial andor VIN Row3: GGood FFair PPoor SScrapSalvageRow3: Round to the nearest dollarRow3: per FA funding typeRow3: CCSFP EEFAP TTEFAP AARRARow3: CityRow3: Agency NameRow3: MonthYearRow4: Item purchasedRow4: Type of equipment brand size for vehicles make model yearRow4: Serial andor VIN Row4: GGood FFair PPoor SScrapSalvageRow4: Round to the nearest dollarRow4: per FA funding typeRow4: CCSFP EEFAP TTEFAP AARRARow4: CityRow4: Agency NameRow4: MonthYearRow5: Item purchasedRow5: Type of equipment brand size for vehicles make model yearRow5: Serial andor VIN Row5: GGood FFair PPoor SScrapSalvageRow5: Round to the nearest dollarRow5: per FA funding typeRow5: CCSFP EEFAP TTEFAP AARRARow5: CityRow5: Agency NameRow5: MonthYearRow6: Item purchasedRow6: Type of equipment brand size for vehicles make model yearRow6: Serial andor VIN Row6: GGood FFair PPoor SScrapSalvageRow6: Round to the nearest dollarRow6: per FA funding typeRow6: CCSFP EEFAP TTEFAP AARRARow6: CityRow6: Agency NameRow6: MonthYearRow11: MonthYearRow21: MonthYearRow31: MonthYearRow41: MonthYearRow51: MonthYearRow61: Item purchasedRow11: Item purchasedRow21: Item purchasedRow31: Item purchasedRow41: Item purchasedRow51: Item purchasedRow61: Type of equipment brand size for vehicles make model yearRow11: Type of equipment brand size for vehicles make model yearRow21: Type of equipment brand size for vehicles make model yearRow31: Type of equipment brand size for vehicles make model yearRow41: Type of equipment brand size for vehicles make model yearRow51: Type of equipment brand size for vehicles make model yearRow61: Serial andor VIN Row11: Serial andor VIN Row21: Serial andor VIN Row31: Serial andor VIN Row41: Serial andor VIN Row51: Serial andor VIN Row61: GGood FFair PPoor SScrapSalvageRow11: GGood FFair PPoor SScrapSalvageRow21: GGood FFair PPoor SScrapSalvageRow31: GGood FFair PPoor SScrapSalvageRow41: GGood FFair PPoor SScrapSalvageRow51: GGood FFair PPoor SScrapSalvageRow61: Round to the nearest dollarRow11: Round to the nearest dollarRow21: Round to the nearest dollarRow31: Round to the nearest dollarRow41: Round to the nearest dollarRow51: Round to the nearest dollarRow61: per FA funding typeRow11: per FA funding typeRow21: per FA funding typeRow31: per FA funding typeRow41: per FA funding typeRow51: per FA funding typeRow61: CCSFP EEFAP TTEFAP AARRARow11: CCSFP EEFAP TTEFAP AARRARow21: CCSFP EEFAP TTEFAP AARRARow31: CCSFP EEFAP TTEFAP AARRARow41: CCSFP EEFAP TTEFAP AARRARow51: CCSFP EEFAP TTEFAP AARRARow61: Disposition Type 1: Disposition Type 2: Disposition Type3: Disposition Type 4: Disposition Type 5: Disposition Type 6: Agency NameRow11: Agency NameRow21: Agency NameRow31: Agency NameRow41: Agency NameRow51: Agency NameRow61: