REQUEST FOR OFF-CAMPUS USE OF TAGGED ITEMS
DEPARTMENT NAME_______________________________________________
REQUESTING PERSON_____________________________________________
Please print
Request permission to remove the following tagged item(s) of State Property from the
Louisiana Tech University Campus:
Tag #____________ Description _______________________S/N________________
Tag #____________ Description _______________________S/N________________
Tag #____________ Description _______________________S/N________________
Tag #____________ Description _______________________S/N________________
The purpose of this request is: ___________________________________________
____________________________________________________________________
Date equipment is to be used: ____________________to___________________
(All forms expire at the end of each academic year)
This completed form must be returned to the property office PRIOR to the removal of equipment.
__________________________________________________________________________
___________________________________________________
Signature of Primary User
___________________________________________________
Signature of Department Property Custodian
___________________________________________________
Signature of Department Head
____________________________________________________
Signature of Property Manager Date Approved
Please note: In accordance with state regulations (Title 34, Part VII/305) “Each person to whom property is entrusted
….shall be liable for the payment of damages whenever his wrongful or grossly negligent act or omission causes any
loss, theft, disappearance, or damage of property for which he is responsible.”
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