Revised As of May 29, 2016
Custody Card
Description:
Date Issued:
Serial Number:
Restrictions:
(in any)
Inventory Number:
Due Date
I understand that I am under financial liability for loss or damage to the item listed above, if the loss or damage results from my negligence,
intentional act, or failure to exercise reasonable care to safeguard, maintain and service it.
Accountable Property Officer
Lender Signature
Accountable Property Officer
Recipient Signature
Property Manager Signature
Fixed Assets Department
P.O. Box 519, Mail Stop 1311, Prairie View, Texas 77446
Phone (936) 261-1916 or 1919