Fillable Temporary Equipment Sign Out Form printable pdf download

Temporary Equipment Sign Out Form

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Return Date:

Short term (< 14 days)

Temporary Equipment Sign Out Form

Please complete this form and submit in person to the

ITS Service Desk

(E251).

We are happy to provide you with the temporary use of our equipment. Please have the signed

equipment returned to IT Services by the above return date.

Name:

Local:

Department:

Room:

Assett #:

Serial #:

Equipment/Item:

Accessories:

Borrower's Signature:

The undersigned agrees to be responsible for the care and safe return of the above described equipment

and accessories.

The undersigned is held responsible to Information Technology Service, Mount Royal University, 4825

Mount Royal Gate, SW, Calgary, for the value of the equipment described above. The obligation remains in effect

until the equipment has been returned in good condition, free from damage or disfigurement. If the equipment is

lost or not returned by the due date, the undersigned agrees to pay for the replacement cost of the loaned equipment.

Should any repairs be necessary, the cost will be responsibility of the undersigned.

Please note: This equipment needs to be available to the entire university. If you are finished with the

equipment before the scheduled time due back, please return all items as soon as possible.

Office Use Only

For Office Use

For Office Use Only

Date of equipment sign out:

Staff:

Int'l:

Date of equipment return:

Staff:

Int'l

Notes:

Temporary Equipment Sign Out Form

Version 1.0

May 11, 2010

Temporary Equipment Sign Out Form

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