This form is to acknowledge that I have been assigned state equipment for use outside of the DOA office premises. I have read DOA Policies 3 and will comply with the provisions of said policy.
I understand that equipment listed above is to be used only by me and only for DOA official business. I agree to do everything within my power to protect and conserve all State-owned property, including equipment and supplies entrusted or issued to me.
Upon completion of the program/project for which this equipment was issued for my use, or a change in duties which eliminates the need for the equipment or when requested by the AT Center, all equipment will be returned to the DOA Section form which it was removed
