B08_Solicitation_Attach_3_DI-105_Property_Receipt_Hand_Receipt.pdf

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Attached to
Eastern States ORC Region 2
Solicitation number
140L0126R0002
Issued by

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This is a Property Receipt (Hand Receipt) form (DI-105) issued by the U.S. Department of the Interior for documenting the transfer of government property to employees or personnel. The form serves as an official record acknowledging receipt and acceptance of property items, establishing accountability and responsibility for their safekeeping.

Section 1 captures property information including the bureau/office cost center, item number, inventory number, detailed description (make, model, manufacturer, serial number), quantity, unit of issue, and acquisition cost across up to 20 line items, with a notes section for additional information. Section 2 documents issuer information requiring the first name, middle initial, last name, title, date issued, signature, and date. Section 3 contains receiver information requiring the recipient's first name, middle initial, last name, title, signature, and date, along with a liability acknowledgment statement whereby the recipient agrees to be solely responsible for proper use, care, and safeguarding of the property, with potential financial liability for loss, theft, damage, or misuse due to negligence or non-compliance with DOI policy. The form is designated as a short-term administrative record with a temporary retention schedule requiring destruction three years after fiscal year cut-off per records disposition authority DAA-0048-2013-0001-0001.

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DI-105 (05/2025)

U.S. Department of the Interior

PROPERTY RECEIPT (HAND RECEIPT)

Section 1: Property Information *required fields

1. Bureau/Office Cost Center:*

2. Item Number

3. Inventory Number

4. Description (make, model, manufacturer, serial number) 5. Qty 6. Unit of Issue

7. Acquisition

Cost

2a. 3a. 4a. 5a. 6a. 7a.

2b. 3b. 4b. 5b 6b. 7b.

2c. 3c. 4c. 5c. 6c. 7c.

2d. 3d. 4d. 5d. 6d. 7d.

2e. 3e. 4e. 5e. 6e. 7e.

2f. 3f. 4f. 5f. 6f. 7f.

2g. 3g. 4g. 5g. 6g. 7g.

2h. 3h. 4h. 5h. 6h. 7h.

2i. 3i. 4i. 5i. 6i. 7i.

2j. 3j. 4j. 5j. 6j. 7j.

2k. 3k. 4k. 5k. 6k. 7k.

2l. 3l. 4l. 5l. 6l. 7l.

2m. 3m. 4m. 5m. 6m. 7m.

2n. 3n. 4n. 5n. 6n. 7n.

2o. 3o. 4o. 5o. 6o. 7o.

2p. 3p. 4p. 5p. 6p. 7p.

2q. 3q. 4q. 5q. 6q. 7q.

2r. 3r. 4r. 5r. 6r. 7r.

2s. 3s. 4s. 5s. 6s. 7s.

2t. 3t. 4t. 5t. 6t. 7t.

8. Notes:

DI-105 (05/2025)

U.S. Department of the Interior

Records Disposition: DAA-0048-2013-0001-0001 – Short-Term Administrative Records Temporary. Cut-off record as instructed in the agency/bureau records manual, or at the end of the fiscal year in which the record is created if no unique cut-off is specified. Destroy 3 years after cut-off.

Section 2: Issued By Information *required fields

9. First Name:* 10. Middle Initial: 11. Last Name:*

12. Title:* 13. Date Issued:*

14. Signature:* 15: Date:*

Section 3: Received By Information *required fields

I understand and agree that I am solely responsible for the proper use, care, and safeguarding of the property issued to me. In the event of loss, theft, damage, or misuse due to negligence or failure to comply with DOI policy, I may be held financially liable for repair, replacement, or associated costs.

16. First Name:* 17. Middle Initial: 18. Last Name:*

19. Title:* 20. Signature:* 21. Date:*

1 BureauOffice Cost Center:
3a:
4a:
5a:
6a:
7a:
4b:
5b:
6b:
7b:
4c:
5c:
6c:
7c:
3d:
4d:
5d:
6d:
7d:
3e:
4e:
5e:
6e:
7e:
3f:
4f:
5f:
6f:
7f:
3g:
4g:
5g:
6g:
7g:
3h:
4h:
5h:
6h:
7h:
3i:
4i:
5i:
6i:
7i:
3j:
4j:
5j:
6j:
7j:
3k:
4k:
5k:
6k:
7k:
3l:
4l:
5l:
6l:
7l:
3m:
4m:
5m:
6m:
7m:
3n:
4n:
5n:
6n:
7n:
3o:
4o:
5o:
6o:
7o:
3p:
4p:
5p:
6p:
7p:
3q:
4q:
5q:
6q:
7q:
3r:
4r:
5r:
6r:
7r:
3s:
4s:
5s:
6s:
7s:
3t:
4t:
5t:
6t:
7t:
8 Notes:
11 Last Name:
12 Title:
13 Date Issued:
15 Date:
16 First Name:
18 Last Name:
19 Title:
21 Date:
9 First Name:
10 Middle Initial:
17 Middle Initial:
3c:
3b:

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