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U.S. DEPARTMENT OF ENERGY <br />FINANCIAL ASSISTANCE <br />PROPERTY CLOSEOUT CERTIFICATION <br />111. REAL PROPERTY: (Real Estate - 10 CFR 600.132, /600.231, 600.321, or FDP General Terms and Conditions No. 32, as <br />applicable) Fl No FlYes (lf ves. complete A —C) <br />A. Description of Real Property: <br />B. Complete Address of Real Property: <br />C. Period of Federal Interest in the Property: From To (Unless the award specifies otherwise, the <br />Federal Interest in the property ends when the award project period ends. ) <br />D. Disposition Preference Request. If the period of Federal Interest in the property exceeds the project period, check one of <br />the following blocks to indicate your disposition preference: <br />❑ Transfer property to another Federal award. <br />❑ Sell and compensate DOE. <br />❑ Return to DOE. <br />❑ Retain title and compensate DOE for its share of the current fair market value of the property. <br />Certification: I certify to the best of my knowledge and belief that all information presented in this report is true, correct and <br />complete, and constitutes a material representation of fact upon which the Federal government may rely. <br />Name I Signature I Title I Date <br />Page 2of3 <br />