Equipment Inventory Intake Record Checklist Form
Complete this form to record and verify equipment received into inventory, including condition and required components.
Date of Intake
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Equipment Name/Type
*
Manufacturer/Brand
*
Model Number
*
Serial Number
*
Physical Condition Upon Receipt
*
New
Good (No visible damage)
Minor Wear/Scuffs
Damaged
Checklist: Required Accessories/Components Received
Power Cable/Adapter
User Manual/Documentation
Protective Case/Packaging
Mounting Hardware
Other (please specify in comments)
Operational Status at Intake
*
Fully Operational
Powers On, Not Tested
Requires Repair
Not Operational
Intake Staff Name
*
First Name
Last Name
Location Assigned/Stored
*
Additional Comments/Notes
Submit
Should be Empty: