IT Equipment Issue Form

IT Equipment Issue Form
*** Pending Acknowledgement by Receiver ***
*** Acknowledged by Receiver ***
Issued To

(Person receiving)
TESTING
Name

First NameLast Name
Office Location
E.g. B113
Email Address
example@example.com
Equipment Details
Type
Description
E.g. Webcam, Projector etc.
Brand/Make/Model
E.g. HP ProBook 650 G8
Serial Number
WITT Asset Number
E.g. TP031234
Additional Items

Other
Issued By

(Person issuing)
Name
Name (Other)

First NameLast Name
Email Address
example@example.com
Date of Issue

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate item(s) issued
Comments
Person Receiving to read below.

By signing this agreement, I agree to the following terms and conditions:
- I understand that I am being issued a laptop as a tool to facilitate my work.
- I understand that I am responsible for the laptop issued to me and that I will care for the equipment in such a manner as to prevent loss or damage.
- The laptop should be transported in its case and stored carefully so it is not susceptible to damage. I may not make any permanent personally identifying marks on the laptop including adhesive labels/stickers.
- The laptop should not be left unattended in any public place.
- The laptop should not be left inside a vehicle where temperature extremes can permanently damage the unit and/or could be visible resulting in theft.
- In case of damages or abuse of the laptop, or because of my failure to follow company technology acceptable use policies, including this agreement, I understand I will be held responsible for payment of repairs or replacement.
- In the event of loss or theft, I am responsible to obtain an incident specific police report immediately and will notify both my Manager and the IT department for repair or replacement.
- The laptop will be returned to the IT team immediately on termination of my employment.
- The laptop is not to be used for personal data and WITT is not liable for lost personal data.
- I agree to the above terms and conditions as such, agree to fully cooperate with property loss reporting requirements and with property loss incident investigations.
- My signature below indicates I have thoroughly read and understand the above information.
Please complete and sign below.
Person Receiving

First NameLast Name
Date Received

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate item(s) received
Receiver's Signature
*** [Date Received] cannot be earlier than [Date of Issue].
Status
Pending OR Acknowledged (Updated by System)
Lock Record
Record locked
Should be Empty:

IT Equipment Issue Form

Issued To

Equipment Details

Issued By