Equipment Issuance Return Form
Please complete all fields to record the return of company equipment.
Employee Full Name
*
First Name
Last Name
Employee ID
*
Department
Please Select
IT
HR
Finance
Operations
Sales
Other
Equipment Type
*
Please Select
Laptop
Monitor
Mobile Phone
Tablet
Docking Station
Headset
Other
Equipment Serial Number or Asset Tag
*
Date of Return
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Return Condition
*
Excellent
Good
Fair
Damaged
Describe Any Issues or Damage (if applicable)
Is Follow-Up Required?
*
No
Yes
Additional Comments or Notes
Submit Return
Should be Empty: