[Company Logo][Company Name]
- Form No.:
- [Reference Number]
- Date of Issue:
- [Date]
- Office / Floor:
- [Work Location] / [Floor]
- Seat / Bay No.:
- [Seat Number]
A. User Details
| Employee Name | [Employee Name] |
|---|
| Employee ID | [Employee ID] |
|---|
| Designation | [Designation] |
|---|
| Department / Process | [Department] |
|---|
| Shift: General / Morning / Evening / Night | |
|---|
| Team Leader / Reporting Manager | [Reporting Manager] |
|---|
B. Hardware Components Issued
| Component | Asset ID | Make / Model | Serial Number | Condition |
|---|
| CPU / Mini PC | [Asset ID] | [Make / Model] | [Serial Number] | [Condition] |
| Monitor | [Asset ID] | [Make / Model / Size] | [Serial Number] | [Condition] |
| Keyboard and Mouse | [Asset ID] | [Make / Model] | [Serial Number] | [Condition] |
| UPS | [Asset ID] | [Make / VA Rating] | [Serial Number] | [Condition] |
| Headset / Webcam | [Asset ID] | [Make / Model] | [Serial Number] | [Condition] |
C. System and Network Configuration
| Hostname | [Hostname] |
|---|
| IP Address / LAN Port No. | [IP / Port] |
|---|
| Operating System and Version | [OS] |
|---|
| Domain Login ID | [User ID] |
|---|
| Printer Mapped | [Printer Name] |
|---|
| USB Storage: Blocked / Allowed with approval | |
|---|
D. Shared Use (for shift workstations only)
| Shift | Employee Name | Employee ID | Signature |
|---|
| [Shift] | [Employee Name] | [Employee ID] | [Signature] |
| [Shift] | [Employee Name] | [Employee ID] | [Signature] |
E. User Responsibilities
- I will use the workstation only for official work and log off or lock the screen when away.
- I will not open the CPU cabinet, swap cables or move any component to another desk.
- I will not connect personal storage devices, phones or unauthorised peripherals.
- I will keep food and liquids away from the equipment.
- I will raise a ticket with IT for any fault instead of attempting repairs myself.
- I will hand over the workstation in working condition when I change seat or leave the organisation.
F. Acknowledgement
I confirm that the workstation at Seat No. [Seat Number] with the components listed above has been allotted to me in working condition, and I agree to follow the company's IT and acceptable-use policy.
User
[Employee Name]Date:
[Date]Installed by
[IT Executive Name]IT Support
Date:
[Date]Verified by
[Admin / Floor In-charge]Date:
[Date]