dd1354 Attch 12.pdf

DoD Form PDF 104 KB Posted

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BASE PAVEMENT
Solicitation number
FA488709R0013
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Attachment 12

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TRANSFER AND ACCEPTANCE OF MILITARY REAL PROPERTY

Form Approved OMB No. 0704-0188

PAGE OF PAGES

1. FROM (Installation/Activity/District and ZIP Code) 2. DATE PREPARED

(YYYYMMDD)

3. PROJECT/JOB

NUMBER

4. SERIAL NUMBER

7. CONTRACT

NUMBER(S)

5. TO (Installation/Activity/Service, ZIP Code & INSNO) 6. SITE/INSNO/

NAME

9. TRANSACTION DETAILS

a. NEW CONST.

EXISTING FAC.

CAPITAL IMP.

OTHER (Specify)

BENF/O

PHYS. COM. AVAIL.

FINANCIAL COM.

OTHER (Specify)

10.

ITEM

NO.

12.

CATEGORY

CODE

13.

CATCODE

DESCRIPTION

14.

TYPE

15.

UNIT OF

MEAS 1

16. TOTAL

QUANTITY

UM 1

19.

COST

23.

ITEM

REMARKS

24. STATEMENT OF COMPLETION. The facilities listed hereon are in accordance with maps, drawings, and specifications and change orders approved by the authorized representative of the using agency except for the deficiencies listed on the reverse side.

25.a. ACCEPTED BY (Typed Name and Signature) b. DATE SIGNED

(YYYYMMDD)

a. TRANSFERRED BY (Typed Name and Signature)

c. TITLE (Area Engr./Base Engr./DPW)

b. DATE SIGNED

(YYYYMMDD)

c. TITLE (DPW/RPAO) 26. PROPERTY

VOUCHER NUMBER

DD FORM 1354, MAR 2004 PREVIOUS EDITION IS OBSOLETE.

b.

8. DRAWING

NUMBER(S)

PARTIAL BOD

c. DRAFT

INTERIM

FINAL d. EFFECTIVE DATE (YYYYMMDD)

11.

FACILITY

NO.

AREA

17.

UNIT OF

MEAS 2

18. TOTAL

QUANTITY

UM 2

OTHER 20.

FUND

SOURCE

21.

FUND

ORG

22.

INTER-

EST

CODE

The public reporting burden for this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE ABOVE ORGANIZATION.

27. CONSTRUCTION DEFICIENCIES (attach blank sheet for continuations) 28. PROJECT REMARKS (attach blank sheet for continuations)

INSTRUCTIONS

GENERAL. This form has been designed and issued for use in connection with the transfer of military real property between the military departments and to or from other government agencies. It supersedes ENG Forms 290 and 290B (formerly used by the Army and Air Force) and NAVDOCKS Form 2317 (formerly used by the Navy).

Existing instructions issued by the military departments relative to the preparation of DD Form 1354 are applicable to this revised form to the extent that the various items and columns on the superseded forms have been retained. The military departments may promulgate additional instructions, as appropriate.

For detailed instructions on how to fill out this form, please refer to Unified Facilities Criteria (UFC) 1-300-08, dated 17 December 2003.

SPECIFIC DATA ITEMS.

1. From. Name and address of the transferring agency.

2. Date Prepared. Date of actual preparation. Enter all dates in YYYYMMDD format (Example: March 31, 2004 = 20040331).

3. Project/Job Number. Project number on a DD Form 1391 or Individual Job Order Number.

4. Serial Number. Sequential serial number assigned by the preparing organization (e.g., 2004-0001).

5. To. Name and address of the receiving installation, activity, and service of the Real Property Accountable Officer (RPAO).

6. Site/INSNO and Name. Site or installation number and site name where the constructed facility is located.

7. Contract Number(s). Contract number(s) for this project.

8. Drawing Number(s). Drawing number(s) or CAD identifier(s) for project components.

9. Transaction Details.

a. Type of Transaction. Mark (X) only one box.

b. When/Event. When or event causing preparation of DD Form 1354. X only one box.

c. Version. Draft, interim, or final DD Form 1354. X only one box.

d. Effective Date. Effective date for transaction; start date for depreciation.

10. Item Number. Use a separate item number for each facility, no item number for additional usages.

11. Facility Number. Unique facility number identified in Real Property Inventory.

12. Category Code. The category code describes the facility usage.

13. Catcode Description. The category code name which describes the facility usage.

14. Type. Type of construction: P for Permanent; S for Semipermanent; T for Temporary.

15. Area: Unit of Meas 1. Area unit of measure; use SF, SY, AC only.

16. Total Quantity UM 1. The total area for the measure identified in Item 15. Use negative numbers for demolition.

17. Other: Unit of Meas 2. Unit of Measure 2 is the capacity or other measurement unit (e.g., LF, MB, EA, etc.).

18. Total Quantity UM 2. The total capacity/other for the measure identified in Item 17.

19. Cost. Cost for each facility; for capital improvements to existing facilities, show amount of increase only.

20. Fund Source. Enter the Fund Source Code for this item, i.e., 01-MILCON, 02-BRAC, 03-O&M, etc.

21. Funding Organization. Enter the code for the organization responsible for replacing this facility at the end of its useful life, i.e., 00-Army Active, 01-Army Reserve, 02-Army National Guard, etc.

22. Interest Code. Enter the code that reflects government interest or ownership in the facility, i.e., 01-Owned by DoD, 02-Owned by Federal Government (non-DoD), etc.

23. Item Remarks. Remarks pertaining only to the item number identified in Item 10; show cost sharing.

24. Statement of Completion. Typed name, signature, title, and date of signature by the responsible transferring individual or agent.

25. Accepted By. Typed name, signature, title, and date of signature by the RPAO or accepting official.

26. Property Voucher Number. Next sequential number assigned by the RPAO in voucher register.

27. Construction Deficiencies. List construction deficiencies in project during contractor turnover inspection.

28. Project Remarks. Project level remarks, continuation of blocks, and used to explain "other" entries in Item 9.

DD FORM 1354 (BACK), MAR 2004

page:
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xfinal: Off
effdate:
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date25:
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