ACKNOWLEDGEMENTOFRECEIPT
OFCOMPANYPROPERTY
Name:_________________________________________ Date:___________________________
DescriptionofEquipmentorPropertyIssuedtoEmployee:
Description/serialnumber
IssuedBy:
BysigningthisformIagreetothefollowing:IacknowledgeIhavereceivedtheequipment/itemsas
listedabove.IagreethatIamresponsiblefortheequipmentissuedtomeandagreeIwilluseitinthe
mannerintended.UponseparationfromMinutemanInternational,Iwillreturntheitemsissuedtome
inproperworkingorder(excludingwearandtear).IalsounderstandthatImayhavetoreplaceany
itemsissuedtomethataredamagedorlostatmyexpense.Iauthorizeapayrolldeductiontocover
replacementcostofanyitemissuedtomethatisnotreturnedingoodworkingorder.
___________________________________________ __________________________
EmployeeDate