Acknowledgement of Receipt
I understand that the equipment issued to me is to be used for company business and belongs to
the company. It is expected that reasonable care be taken when operating company property so as to
be able to return it in good operating condition including all accessories included with the product such as
chargers, batteries, etc. I further understand, acknowledge, and authorize that my paycheck, including
my final one, may be deducted for the value of the equipment, or if a key is not returned the cost to
re-key the office. I also understand, acknowledge, and authorize that if I incur additional charges
such as overage for cell phones that I authorize a deduction from my paycheck for those charges.
I also understand that if I do not comply with these provisions, my access to company property may
be revoked, and I may be subject to disciplinary action up to and including discharge.
Signature Printed Name Date
By initialing below, I acknowledge that I have received the following company property:
Initial Item Value Date Issued Date Returned