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Laptop Check-out Form General Information Name: Department: Phone: Description of Laptop Manufacturer: Model: Asset #: Serial #: Items Issued CD-ROM Modem/Adapter DVD Mouse (without dock station) Floppy Disk Network Card/Adapter Laptop Parallel Connector (A: drive) Laptop Bag Power Cord Other: Reference Number: Date: Return Date: Signature Date: Technician's Signature Date: Click to Add Company This agreement ensures that the equipment borrowed from the IT department will be used and maintained by the designated borrower named below. By signing this form, the borrow accepts all responsibility. Please do not install any software of any kind. Please ask for IT assistance if another software is needed.