Equipment Request/Release Form

Equipment Request/Release Form
Borrower Name
First NameLast Name
Department
Date of Removal
MonthDayYear
Date
Equipment Information
Number of Borrowed Equipment
Type of Equipment
Reason for Use
By signing below, the borrower acknowledges that he/she is responsible for the any damage to the items/equipment.
Borrower Signature
Clear
Additional Details/Comments
Authorized Name
First NameLast Name
Authorized Signature
Clear
Should be Empty: