IT Employee Equipment Request / Allocation Form

First Name: Last Name:

Position: Employee Number:

Employee Location /Duty Station: Department:

ITEM REQUESTED MAKE/MODEL SERIAL / PRODUCT NUMBER DESCRIPTION (IF ANY)

TERMS.
By signing this form, I, the employee, acknowledge that the equipment above is company-owned
and that it is to be used for work-related purposes. I am responsible for the care and well
maintenance of the equipment. Incase the equipment gets broken due to wear and tear, I shall
have it inspected with the company’s IT department as soon as possible. I understand that upon
the termination of my employment I shall surrender and turn over the equipment back to the
company.
By signing this agreement, I acknowledge that the office equipment described above is in working
order and I confirm to the terms and conditions for the said equipment.
Employee Name ………………………………………….. Sign ………………………………. Date……………………….
Request Approved by: Name ………………………………. Sign ………………………………….. Date……………………...…..

Request issued by: Name…………………………………… Sign ………………………………….. Date……………………………

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