Lockbox Checkout Log Form
Log each lockbox checkout and return accurately. Please complete all relevant fields.
Lockbox Identifier
*
Borrower Full Name
*
First Name
Last Name
Department or Team
*
Checkout Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Expected Return Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Purpose of Checkout
*
Lockbox Condition at Checkout
*
Please Select
Excellent
Good
Fair
Poor
Other
Accessories/Items Included
Keys
Entry Cards
Documentation
Other
Return Date and Time
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Return Condition / Notes or Issues
Submit Log
Should be Empty: