EQUIPMENT SIGN-OUT FORM

EQUIPMENT SIGN-OUT FORM

I hereby certify that my name and employees ID number are correct. I understand that by signing out the equipment, I assume responsibility for its condition, and will accept any charges that go towards replacement or repair in the event that the equipment is lost or damaged.

NOTE: ALL EQUIPMENT MUST BE RETURNED IN RESET CONDITION.
Date Out Time Out Employee's Name ID Number Equipment
(be specific: scale, glove, etc)
Staff Initials Date In Time In Staff Initials