Technology Equipment Sign-Out/Return Form
I have received the item(s) listed below from the Harlan County Schools Technology Department.  I agree that all equipment will be used in the performance of my job duties and will not be loaned to anyone else.  If the item(s) are for warranty work, the failed item(s) shall be returned to the Technology Department for processing warranty repair.

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I have received (device): *
Required
Model: *
Harlan County Schools Asset Tag #:
Device Serial number\Service Tag:
Location *
Requested\Received by: *
Date issued:
MM
/
DD
/
YYYY
Date returned:
MM
/
DD
/
YYYY
Staff member overseeing sign out: *
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