Title Page

  • Employee Name

  • Department

  • Prepared by

  • Date & Time

  • Location

Equipment Sign Out

  • Click "Add"

  • Item
  • Item/ Equipment Issued

  • Quantity

  • Equipment Condition

Issuance

  • Date Issued

  • Do you need to specify a return date?

  • Return Date

  • I agree to comply with the ESS safe work policies of using this equipment in accordance with the training and instruction provided and will return the equipment on time.

  • Employee Number (if available)

  • Employee's Full Name & Signature

Completion

  • Additional Notes

  • Full Name & Signature of Approver

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.