Item Exit Check Form
Complete this form to verify and document the eligibility of an item for exit.
Item Name
*
Item ID or Serial Number
*
Item Condition at Exit
*
Please Select
Excellent
Good
Fair
Damaged
Is the item authorized for exit?
*
Yes
No
Exit Reason
*
Please Select
Transfer
Disposal
Repair
Other
Exit Location
*
Date and Time of Exit
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Person Responsible for Item Exit
*
Additional Notes (if any)
Submit Check
Should be Empty: