Equipment Property Request - Razor Planet

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New Destiny Church International

4500 E Speedway Blvd., Suite 110

Tucson, AZ 85712

Phone: 520)323-8852

dci.nu

Equipment Property Request

Name:

Department:

Address:

Phone:

Date Requested

Item Description

(Make, Model, Serial No.)

Date needed

Quantity

Return Date

I accept full responsibility for the above item(s) while it is in my care. I understand that I will be held liable if the equipment is

lost, stolen, or damaged while in my care and will immediately notify a Deacon or Elder within New Destiny Church

International. I understand that it is my responsibility to notify New Destiny's Church's deacon ministry if I intend to use the

item beyond 30 days. It is my responsibility to get authorization and I understand that the above item(s) will be reissued on a

30-day basis.

Requestor's

Signature:

Authorized By:

Date:

Date:

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