Fillable Printable Personal Custody Property Record Hand Receipt
Fillable Printable Personal Custody Property Record Hand Receipt
Personal Custody Property Record Hand Receipt
NOAA FORM 37-40 (1/99)
PERSONAL CUSTODY PROPERTY RECORD/HAND RECEIPT
PROPERTY ISSUED TO:
NAME: (LAST) (FIRST) (M.I.)
DIVISION/BRANCH LOCATION:
ROOM/BUILDING
HOME PHONE NO.
Statement of Responsibility:
I have received the item(s) listed below on the date indicated. I accept personal responsibility for the property and will surrender it upon demand,
transfer, or separation from the Government. I further understand that failure on my part to exercise responsibility for the care and protection of the
item(s) listed below could result in pecuniary liability established in accordance with DOC Personal Property Management Policy Manual, Part 4.9.
BAR CODE NUMBER DESCRIPTION
(INCLUDING MAKE, MODEL, SERIAL NUIMBER AND ACCESSORIES)
COST
NAME OF PERSON RECEIVING PROPERTY TELEPHONE NO. ITEMS ARE TO BE RETURNED TO:
ISSUING OFFICE LOCATION
SIGNATURE: DATE
NAME OF ISSUING PROPERTY CUSTODIAN: RETURNED: DATE
SIGNATURE: RECEIVED - SIGNATURE OF PROPERTY CUSTODIAN:
