LOG FOR UNIVERSITY-OWNED POOLED DEVICES
FORM INSTRUCTIONS

Form Instructions

1. Print Name - Print the name of the individual to whom the device is being assigned.
2. Date - Enter the date the device is being assigned.
3. Business Purpose - enter the business purpose for which a device is required.
4. Time Out - Enter the time the device is being logged out to the individual.
5. Time In - When the device is returned, log the time.
6. Signature - The employee returning the device signs within this box.
7. Supervisor Name - Print the name of the supervisor.
8. Signature - The supervisor signature.
9. Date - The date the supervisor signs this form is enter.