Office Property

"*" indicates required fields

Employee Name*

Department*

Title*

I hereby acknowledge that I have received the following company property:*

Name of Item

Serial/Identifying Number

Date of Receipt

Terms & Condition*

I agree to keep the property safe and in good working condition. To notify the management in the event of any damage, malfunction or loss of the property. I hereby agree to repair any damage to or loss the property caused by my carelessness/ negligence. Further, I agree to return this property at the end of my employment and when I no longer need one or more of the items, I will return immediately to my supervisor.

I agree

Employee Full Name*

First Name Middle Name Last Name

Supervisor’s Name*