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Equipment Return Receipt Form
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This letter is to document that the following equipment were received:
*
iPad
iPad Charger
iPhone
iPhone Charger
Laptop
Laptop Charger
Printer
Fax Machine
Scanner
Laminator
Other
Other: Please Specify
Name of Person Returning Equipment
*
First
Last
Date Returned
*
MM slash DD slash YYYY
Signature
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Passcode
*
EAS Designee Receiving the Equipment:
Name of Person Receiving Equipment
*
First
Last
Position
Date Received
*
MM slash DD slash YYYY
Date Released to Company
MM slash DD slash YYYY
Are items in good condition?
*
Yes
No
Please discuss in detail:
Signature of Employee Receiving Equipment
*
Please sign here once endorsement is complete.
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Home
About Us
Our Services
Early Intensive Behavioural Intervention
Occupational Therapy
Speech Pathology
What is Applied Behaviour Analysis
School and Kinder Readiness
Our Locations
Australia
Victoria
Cranbourne Clinic
United States
Alabama
Birmingham
Montgomery
Georgia
Atlanta
Duluth
Idaho
Illinois
Chicago
St. Louis
Maryland
Michigan
Ann Arbor
Detroit
Missouri
Oregon
Portland
Salem
Tennessee
Virginia
India
Karnataka
West Bengal
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