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Asset Acknowledgement Form

Please fill out one form per piece of asset. Field marked with * are mandatory.
Contact Information:
Name Designation:*

Organization Phone:*

Div/Dept/* Email:*

Item Detail:

Item Type:* New Used

Item Name:*
Description/ Specification:*

Item Condition

Undertaking:-

I hereby confirm that I have received the asset in good shape. I have personally checked the specifications of this item
and I certify that the item received by me is according to the specifications mentioned above. I ensure that this item will
be handled with care. This Item remains the property of the organization and will be returned back whenever needed by
the organization.

Signature:

Date:

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