I acknowledge and agree that (company name) will loan me the following equipment to assist me with job duties and work related assignments.
I agree to follow all company policies and procedures regarding the safeguarding of these company assets and acknowledge that I will be personally responsible for any loss or theft of the company assets described below while it is under my assignment. Release of responsibility may only be occasioned by strict adherence to company policies and proceduresregarding safeguarding of these assets. THIS EQUIPMENT AND ALL RELATED SOFTWARE REMAINS THE SOLE PROPERTY OF (COMPANY NAME)., I UNDERSTAND THAT I AM NOT PERMITTED TO INSTALL ANY SOFTWARE FOR ANY PURPOSES UNLESS EXPRESSLY AUTHORIZED, IN WRITING, BY THE INFORMATION SERVICES DEPARTMENT.
I agree that in the event I leave (company name) employment voluntarily or non-voluntary I shall return the described equipment within five days of my last active day with the company.
I hereby allow (company name) to use reasonable means including, but not limited to, withholding pay to recover losses due to my failure to adhere to company policy and procedures.
If notebook computers, projectors, and other (company name) assets are transported outside of the home; note that company property may not be covered if stolen or lost by a homeowners policy, we suggest you review your policy.
I acknowledge that I received on loan the following items of (company name) property:
(list of equipment)
(signatures)
