PROPERTY CONTROL FORM NO. 4
Revised: June, 2014
“REQUEST FOR HOME/OFF-CAMPUS USE OF STATE PROPERTY”
TO: Director of Property Control Date: _______________________
FROM: _________________________________________________________________
(Name)
_________________________________________________________________
(Department)
I request the home/off-campus use of the following State Property for university business only:
TAG NUMBER DESCRIPTION
_______________________________ _______________________________________________
_______________________________ _______________________________________________
_______________________________ _______________________________________________
If item is a laptop, please state if Computrace Software is installed: Yes or No:____________
Date Required: __________________________ Date of Return: ____________________________
Reason for Request: ____________________________________________________________________
_______________________________________________________________________________________
**This form is to acknowledge that I have been assigned state equipment for use outside of Nicholls State University office
premises. I have read the NSU Property Section Policy, 11.6 and will comply with the provisions of said policy. I understand that
the equipment listed above is to be used only by me and only for NSU official business. I agree to do everything within my power
to protect and conserve all State-owned property, including equipment and supplies entrusted or issued to me. Upon completion
of the program/project for which this equipment was issued for my use, or a change in duties which eliminates the need for the
equipment, or when requested by my supervisor or section head, all equipment will be returned to NSU from which it was
removed.
**I understand that I shall be responsible for the equipment while in my care and that the item or items shall be returned to
campus on a daily basis when I report to work.**
___________________________________________
Employee’s Signature
APPROVALS:
Department Head: ____________________________________
Dean:______________________________________________
Director of Property Control:____________________________
DATE RETURNED: ________________________________
___________________________________________________
Employee’s Signature
___________________________________________________
Employee’s Supervisor’s Signature
NOTE: The original approved form must be kept with the piece of equipment at all times. An approved copy shall also be kept on
file in your department where it can be easily located upon request by the Property Control Office. When the property is returned
to the University, the completed original form must be forwarded to the Property Control Office. All laptops are required to have
Computrace Software installed prior to receiving approval for off campus use. Please contact Computer Services through their
online system to verify if your laptop has the required software. Go to https://csapps.nicholls.edu/helpdesk/index.php and send
message requesting Computrace Software verification.
