FASS STUDY MATERIALS LOAN FORM
PLEASE READ THE ENTIRE FORM BEFORE SIGNING
Fill out all highlighted sections and give to President (one form per item)
FASS Member Name (Borrower) __________________________________________________________
UF ID number ______________________________________________________________________
Loaned Materials Description __________________________________________________________
__________________________________________________________________________________
Condition of Materials ________________________________________________________________
Loan Dates: Start Date ____/____/____
Due Date ____/____/____ (maximum of 1 week for manuals)
Email address ______________________________________________________________
Phone Number: ____________________________
Certification: I certify that the loaned study materials will be used for my preparation of my upcoming exam.
The materials will be secured to prevent theft. The materials will be returned to the President of the Florida
Actuarial Student Society (FASS) on or before the due date specified above. I understand that I am
responsible for theft, loss, or damage of this property. If I cannot return the materials that I borrowed by the
due date and in good condition, then I am responsible for paying the FASS the price of a replacement. A
comparable replacement will be sought, but it is possible that one is not available at the time. Therefore this
payment could include the purchase of a brand new material (possibly even a newer edition if same edition
is no longer available) even though the one loaned was used or of an older edition.
Student Signature (Borrower): _____________________________________
Date: _________________
***************Read the rest of the form and fill out the bottom, highlighted portion***************
Authorized Loaner Approval:______________________________________________Date:_____________
Signature/Printed Name/Office Held
This form should be completely filled out and kept on file in the possession of the President of the FASS for
inventory verification.
Return of Materials:
Condition of Materials: ___________________________________________________________________
Signature of Borrower: ________________________________________________ Date: _____________
Signature of Authorized Loaner:_________________________________________ Date:_______________
Printed Name of Loaner/Office Held_________________________________________________________
Do not return the materials without signing it back in on this sheet. If this sheet is not
signed for returned materials, this form will override any verbal contract.
I,___________________, have read and clearly understand everything on this form.
______________________________ _________________________ _______
Signature of Borrower
Borrower’s Printed Name
Date
______________________________ __________________________ _______
Signature of Witness
Witness’s Printed Name
Date