RETURN OF IT ASSETS FORM

(ASIRVAD IT INSTRUMENTS AND ACCESSORIES – MANAGEMENT POLICY (A NNEXURE 1)

Name: Branch: Division:

Emp ID: Designation: State:

DOJ: HandoverDate
:

I hereby declare that:

I have returned the below issued list of items indicated in tick boxes in the condition mentioned in
below table to the responsible manager/supervisor/ Admin advised to attend to retain:

Recoveree Details:
EmpID : __________________________
EmpName :___________________________
Designation :____________________________
Date :__________ __ _______________

Sl. No Item Name Model Serial Number/ Condition Qty

1 JIO Mobile with F120B Black IMEI:
charger
2 JIO Sim Card MobNo: SIM:

3 Samsung Tab with

Charger
4 Printer with Charger

5 Laptop/Mini Laptop
with Adapter
6 CUG SIM Card MobNo:
7 Data Card SIM:

8 Mouse

9 Pen Drive

_______________ _______________
EMPLOYEE DATE

I ___________________________ hereby confirm that I have received all company property/assets

indicated in tick boxes.

_______________ _______________
Manager/ Supervisor/HR DATE
Asirvad/ISMS/Policies/Forms Version No. 1.0 Doc No: AML0017

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