Equipment Liability Form

Equipment Liability Form
The following acknowledgment form has been created to highlight the procedures for equipment signed out to BEAT AIDS employees. Please note is one form per device.
I understand that I am responsible for any and all fees if my equipment is lost, stolen or broken. You agree to pay the original cost of the item.*
I must report any damages done to the equipment within 24 hours.*
I understand that under no circumstance should I leave my equipment unattended as it may contain confidential information.*
I understand that at no time I am allowed to download any applications unless approved by the Department Director.*
I understand that if I am terminated or resign and I do not return all equipment I consent to get the retail price deducted.*
I Your Name*, have received the above instructions and an internal training covering the care of equipment and the usage of my assigned electronic device.
Device Brand
Device Model / Generation (Tablets)
Device Model can be HP Pavilion, Dell OptiPlex, Dell Latitude, Apple iPad, Apple iPhone, etc.
Equipment Type*
mobile phones/tablets, laptops, desktops, monitors, printers, credit card readers and locks
Serial Number*
Date Received*

MonthDayYear
Date
Passcode (ONLY for iPads/Square Machines)
Date Returned

MonthDayYear
OFFICE USE ONLY
Employee Signature*

Clear
Email*
example@example.com
Employee Name
Supervisor*

First NameLast Name
Supervisor
Notes
Take Photo of Device Serial Number (This option is only if you are using a phone to submit this form)
Does your device have a label with "PROPERTY OF BEAT AIDS" + "Serial Number / Device ID"

YesNo
Should be Empty: