11 - 020P Preparation of Furnished Equipment Form

A. USNH 11-020F: Furnished Equipment Form

Form: USNH 11-020F: Furnished Equipment Form
Obtain Blank Forms From:

USNH 11-020F: Furnished Equipment Form
USNH Property Control

Forward Completed Forms To:

USNH Property Control
5 Chenell Drive, Suite 301
Concord, NH 03301


B. Purpose of USNH 11-020F: Furnished Equipment Form

Purpose of Form USNH 11-020F: To provide information on items which are in the custody of USNH personnel, but not owned/used by USNH. These items are tracked by USNH but are not recorded by USNH or barcoded by USNH. Receipt of sponsored government furnished equipment should be reported to USNH Property Control and STAR by the department receiving the equipment. Furnished equipment is titled to the government and reports must be filed concerning government-owned equipment.

C. Instructions for Completing USNH 11-020F: Furnished Equipment Form

1. Required Custodial Information


Name of the department receiving the equipment

Orgn Code:

Banner Orgn code associated with the above department

Date Received:

Date the equipment was received by the department

Furnishing Agency:

The agency or institution the equipment was received from

Agency Code:

Banner USNH ID code associated with the furnishing agency


Address of the furnishing agency/institution

Grant Name:

The grant name associated with the equipment

Grant Code:

Banner grant code associated with the equipment

Equipment Custodian:

Name of the person who is responsible for the location and the use of the equipment while it is at the University

Custodian ID:

USNH ID # of Equipment Custodian/Manager


2. Required Information about the Equipment:


A clear description of the equipment

Serial #

The unique identification number which manufactures often assign to each piece of equipment. This can usually be found of the piece of property.

Model #:

The manufacturer's model number


The name of the company or organization which produced the equipment

Estimated Value:

Value given to the item by the provider. If no value has been given, use an estimated value.

Estimated Age:

Approximate age of equipment in years


Condition of equipment


The building name, number, and room where the equipment will be housed while at the University

This page last updated Tuesday, April 18, 2023. For information on the adoption and effective dates of policies please see explanation on the OLPM Main Menu.