• Title or Description

  • Property Tag or Serial Number

  • Condition

  • Notes

  • Returned

  • Returned On

  • Notes

Important Stuff

Loan Details

  • Return Date

  • Return By

  • Notes

Important Stuff

  • By signing below, you agree to accept full financial responsibility, either personally or on behalf of your department (whichever is applicable), to replace any lost, stolen, or damaged items at the original purchase price of the item(s) indicated in the Items section of this form. You also agree to return the item(s) indicated by the return date; if the item(s) are not returned in a timely manner, you may be held financially responsible for replacement of the item(s). Furthermore, until the item(s) are either replaced or returned, you will forfeit the ability to borrow equipment in the future. Note: the item(s) loaned to you may be reporting geolocation data as part of an asset management and anti-theft system.

  • Institutional Email

  • Recipient Signature

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