Agreement for Equipment Located Off-Campus
Instructions:
Please complete the information requested for College equipment listed on the fixed asset inventory but located off-campus by agreement with College
employee users in your department. Complete an individual form for each employee assuming responsibility for equipment not located on main campus, sign
and send original to Financial Services.
Note: As a College employee user of the equipment listed on this form, I agree to return the equipment when requested and complete a new transfer
form if I still have the equipment in my possession at the annual inventory date. While signed out to me if the equipment is lost, stolen or damages
as a result of my negligence (carelessness) or wrong doing or not returned when requested by the department head or Financial Services, I agree to
repay the equipment’s fair market value.
Department: College Employee User (Print Name):
Phone: Date: College Employee User Signature:
Division Chair (print): Phone:
Division Chair (sign): When the item is returned to campus, fill in the Return Date, Building/Room No. and send a copy to Financial Services.
Removal Date: Actual Return Date:
Expected Return Date: Returned to Location:
Asset Tag
Number
Description/Manufacturer
Serial No.
Off-Campus Location
(Address)
Equipment Cost
Signatures
Person Making Request Date Business Office Manager Date
Department Head Approval Date
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