Assignment Of Fixed Asset To Student printable pdf download

Assignment Of Fixed Asset To Student

Form H-1

Revised 09302011

Hinds County School District

Assignment of Fixed Asset to Student

(Hand Receipt)

FROM: __________________________________________________________________________

(NAME OF STUDENT CHECKING OUT EQUIPMENT)

TO: CFO - Director of Business Services and Operations

This is to verify that I, the above referenced student, have requested and been approved to check out the

equipment listed below:

Bar Code

Description of Equipment

Serial Number

Number

By signing below, I acknowledge that both I and my parent have read the Hinds County School District

policy on the reverse of this form. I also acknowledge that I and my parent are fully liable for all damage,

loss, or theft of the equipment while in my possession. In the event that the equipment is not returned in

the condition that it was received, we agree that all costs associated with the replacement or repair of the

equipment will be paid.

_______________ _________________ _______________ ________________ ________________

Student Signature Parent Signature

Teacher Signature Principal Signature Date Out

_______________ _________________ _______________ ________________ ________________

Student Signature Parent Signature

Teacher Signature Principal Signature Date Returned

Assignment Of Fixed Asset To Student