Equipment Summary Report Form
Please complete this form to provide a detailed summary of the equipment.
Equipment Name
*
Equipment ID or Asset Tag
*
Equipment Type
*
Please Select
Electrical
Mechanical
IT/Computing
Laboratory
Vehicle
Other
Manufacturer
Model
Location
*
Condition
*
Please Select
Excellent
Good
Fair
Poor
Out of Service
Date of Inspection/Report
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Last Service Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Responsible Person
*
First Name
Last Name
Additional Comments or Notes
Submit Report
Should be Empty: