Employee Receipt for Company Property

Employee name:
Employee number:
Department:
Social Security number:

I acknowledge receipt of the below listed company property. I
agree to maintain the property in good condition and to return
it when I terminate employment with the company or when
requested by my supervisor. In addition, if I no longer need any
of the items, I will report this information to my supervisor. I
agree to notify the company if any of the items are damaged,
destroyed, or lost.

Receipt Returned

Date Issued
Item
Serial No.
Returned to:
Date


________________________________
Signature of Employee

Date