Acknowledgement of Receipt of Company Property, Terms and Conditions
I,_____________________________________________________________the undersigned
ID Number __________________________________________________________________
Residing at (Home address)_____________________________________________________
Hardware issued
Condition
Comments
Date
By signing this form, I agree to the following: I am responsible for the equipment or property issued to me; I
will use it/them in the manner intended; I will be responsible for any damages done (excluding normal wear
and tear); upon separation from the Company, I will return the item(s) issued to me in proper working
order(excluding normal wear and tear); I will replace any items issued to me that are damaged or lost at my
expense; I authorise a payroll deduction to cover the replacement cost of any item issued to me that is not
returned for whatever reason, or is not returned in good working order. Should there be any insurance claim, I
will be responsible for the excess payment for the claim.
In the event of my employment being terminated at [YOUR COMPANY NAME], unless otherwise specified, I
understand that the equipment remains the property of [YOUR COMPANY NAME] and I will return the
property to the company in a good and working condition with all accessories supplied at issue, and during the
course of my employment period at [YOUR COMPANY NAME]. I will also undertake to ensure the safe keeping,
maintenance of the hardware and all confidential data stored on the equipment at all times, and while in my
possession.
I further undertake that in the event of [YOUR COMPANY NAME] taking legal action against me, to pay their
attorney/ client legal cost including collection commission. Collection commission will be payable by me on all
payments made to the afore mentioned attorney.
In the event that hardware is swopped out, upgraded or changed, please complete this form.
Old hardware
New hardware
Condition
TO BE COMPLETED BY SUPPORT ENGINEER
Comments
Date
Asset Type
Model
Serial#
EMEI
CPU
RAM
HDD / SSD size
I, _________________________ hereby confirm that all information entered above is accurate, documented
on the IT Asset Register and has been prepared correctly per the standard operational procedure.
Signed at __________________________________on the __________ day of
________________________20__
Signed by(name):__________________________________
____________________________________________
Employee: _________________________________ ______
Manager:__________________________________________
Signed by(IT Engineer):__________________________________
____________________________________________
Signed by(IT Manager):__________________________________
____________________________________________