STATE OF CALIFORNIA
|STATE OF CALIFORNIA |The Unit Coordinator initiate’s this form when an employee|
| |is issued state property on the first day of hire and |
|RECORD OF PROPERTY ISSUED TO EMPLOYEE |maintains its accuracy throughout the employee's tenure |
|Form # (Issue/Revision Date)) |with the Unit. |
|Section I To be completed by Unit Coordinator |
|1. EMPLOYEE NAME |UNIT |
| | |
| HOME ADDRESS |CITY AND ZIP CODE |HOME TELEPHONE NO. |
| | |( ) - |
| START DATE |SUPERVISOR |
| | |
|2. ITEMS ISSUED: | |OTHER ASSET ID |DATE ISSUED |DATE RETURNED |
|NameplatE | | | |
|ID CARD | | | |
|Building Card Key # | | | |
|Furniture/Modular Keys | | | |
|Restroom/Office/Storage Keys | | | |
|PAGER# | | | |
|CELL PHONE SN/ASSET ID# | | | |
|PERSONAL DIGITAL ASSISTANT (PDA) DEVICE SN/ASSET ID# | | | |
| | | | |
|Building Card Key # | | | |
|Furniture/Modular Keys | | | |
|Restroom/Office/Storage Keys | | | |
|DGS Charge Card # | | | |
|PARKING CARD # | | | |
|CALCULATOR | | | |
|LAPTOP SN/ASSET ID# | | | |
|PROJECTOR SN/ASSET ID# | | | |
|COMPUTER SN/ASSET ID# | | | |
|SOFTWARE | | | |
|PRINTER SN/ASSET ID# | | | |
|USB FLASH DRIVE SN/ASSET ID# | | | |
|NETWORK ACCESS | | | |
|EMAIL ACCESS | | | |
|REMOTE ACCESS | | | |
|OTHER ACCOUNTS | | | |
|OTHER ITEM | | | |
|OTHER ITEM | | | |
| | |
|EMPLOYEE SIGNATURE: |DATE: |
| | |
|SUPERVISOR SIGNATURE: |DATE: |
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