DEPARTMENT: DATE

FINANCE PREPARED:
DEPARTMENT February 21, 2023
EMPLOYEE’S CONTROL NO.:
NAME:
WYLYNE NATICHO 2023-0001
– C/O MARICEL
TAN

ITEM
DATE ISSUED QTY DESCRIPTION VALUE /COST DATE REMARKS
(Ex. Serial No./Color/Model/Unit) RETURNED

FEB. 21, 2023 1 DESKTOP

DELL
1 CPU
1 KEYBOARD

I, __________________________(Employees’ Name) acknowledge that I have received the company property indicated above. I understand that it is my responsibility
to keep the above described property secure so it is not lost, stolen, damaged or otherwise rendered unusable or serviceable except through normal wear and tear.

I understand that it is my responsibility to return the above described property or any substitution/replacement which I may receive upon the end of my employment and
that the failure to do so will result in deduction of its fair value or replacement cost from my paycheck, final or otherwise, for each item not returned.

I authorized__________________________(Company’s Name) to deduct for any unreturned or damaged property. Nothing in this authorization shall be construed to
limit the at-will employment relationship myself and (Company’s Name).

Acknowledged and Received by: ___________________________________________

Prepared by: __________________________________________