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Series:_____________

Date:______________

Accountability Form

Name:______________________________________________ Designation:______________________
Locker Number: ______________________________________ Location: _________________________
Department: ________________________________________ Cellphone Number: ________________
Direct Superior:______________________________________
Email Address: _______________________________________

List of Items:
1. Locker
2. Padlock with Key

Guidelines on Locker Use:


1. Do not stick any pictures and stickers in the locker.
2. Maintain cleanliness.
3. Any lost or damage referring to the locker and padlock will have corresponding charges.
4. Management has the right to access lockers at its discretion.

________________________ _______________________
Signature Approved By

Series:_____________
Date:______________

Accountability Form

Name:______________________________________________ Designation:______________________
Locker Number: ______________________________________ Location: _________________________
Department: ________________________________________ Cellphone Number: ________________
Direct Superior:______________________________________
Email Address: _______________________________________

List of Items:
1. Locker
2. Padlock with Key

Guidelines on Locker Use:


1. Do not stick any pictures and stickers in the locker.
2. Maintain cleanliness.
3. Any lost or damage referring to the locker and padlock will have corresponding charges.
4. Management has the right to access lockers at its discretion.

________________________ _______________________
Signature Approved By

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