Vehicle Equipment Checkout Form
Complete this form to record vehicle equipment checkout details. Please ensure all information is accurate before submitting.
Employee Name
*
First Name
Last Name
Employee ID
*
Equipment Item
*
Please Select
Fire Extinguisher
First Aid Kit
Tool Kit
Jump Starter
Spare Tire
Other
Vehicle ID or License Plate
*
Date and Time of Checkout
*
 -
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
Odometer Reading (at checkout)
Equipment Condition at Checkout
*
Please Select
Excellent
Good
Fair
Needs Attention
Purpose of Checkout
Supervisor Name (if required)
Submit Checkout
Should be Empty: