Page 118 - New Hire Orientation Packet 6.17
P. 118

EMPLOYEE EQUIPMENT CHECK-OUT LIST


             Employee Name:                          Department:                             Title:

             I acknowledge that I received the equipment described below and that I am responsible for the
             proper use and return of the equipment.  I am aware that I must inform the HR department should
             any of the equipment listed below become damaged, lost, or stolen. Further, I acknowledge that I
             may be held financially  responsible  for the  replacement  of the  equipment below  should the
             equipment become damaged or lost due to my negligence.


                                                                                        Signature



                                  Site Where
               Equipment         Equipment is                                         Employee         Issuer
                  Issued            Located          Issued by       Date Issued        Initials       Initials
                                  (if applicable)






















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