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DOE F 4420.2
(11-01)
All Other Editions Are Obsolete

OMB Control No.
1910-1000

U.S. Department of Energy

Personal Property Loan Agreement

OMB Burden Disclosure Statement
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 this burden, to Records Management
Division, IM-11 GTN, Paperwork Reduction Project (1910-1000), U.S. Department of Energy, 1000 Independence Avenue, S.W., Washington, DC 20585;
and to the Office of Management and Budget (OMB), Paperwork Reduction Project (1910-1000), Washington, DC 20503.
DOE-PMR 109-1.5103

1. CONTROL NUMBER

5. NAME-ADDRESS-TELEPHONE NO./FAX/EMAIL (LENDER)

2. LOAN DATE

4. PAG