Free register template · Word

Safety Equipment Issue Form

The safety equipment issue form is the stores register that tracks every item of PPE and safety gear handed out: helmets, safety shoes, gloves, goggles, ear plugs, harnesses and reflective jackets. It shows who received what, in which size, when replacement is due, and when items were returned or replaced.

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[Company Logo][Company Name]

SAFETY EQUIPMENT / PPE ISSUE REGISTER

Plant / Site:: [Work Location]
Store:: [Store Name]
Month:: [Month / Year]
Storekeeper:: [Storekeeper Name]

Issue Record

Date	Worker Name	Employee ID / Contractor	Item	Size	Qty	Replacement Due
[DD/MM/YYYY]	[Employee Name]	[Employee ID]	Safety helmet	[Size]	1	[DD/MM/YYYY]
[DD/MM/YYYY]	[Employee Name]	[Employee ID]	Safety shoes	[Size]	1 pair	[DD/MM/YYYY]
[DD/MM/YYYY]	[Employee Name]	[Contractor Name]	Cut-resistant gloves	[Size]	[Number]	[DD/MM/YYYY]
[DD/MM/YYYY]	[Employee Name]	[Employee ID]	Full-body harness (Serial [Number])	[Size]	1	[DD/MM/YYYY]
[DD/MM/YYYY]	[Employee Name]	[Employee ID]	Ear plugs / ear muffs	-	[Number]	[DD/MM/YYYY]

Returns and Exchanges

Date	Worker Name	Item Returned	Condition	Replacement Issued
[DD/MM/YYYY]	[Employee Name]	[Item]	[Worn / Damaged / Good]	[Yes / No]
[DD/MM/YYYY]	[Employee Name]	[Item]	[Worn / Damaged / Good]	[Yes / No]
[DD/MM/YYYY]	[Employee Name]	[Item]	[Worn / Damaged / Good]	[Yes / No]

Monthly Stock Summary

Item	Opening Stock	Received	Issued	Closing Stock	Reorder Level
Safety helmet	[Number]	[Number]	[Number]	[Number]	[Number]
Safety shoes	[Number]	[Number]	[Number]	[Number]	[Number]
Gloves	[Number]	[Number]	[Number]	[Number]	[Number]
Goggles	[Number]	[Number]	[Number]	[Number]	[Number]

Storekeeper
[Storekeeper Name]
Date: [Date]

Safety Officer
[Name]
Date: [Date]

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What this template includes

Worker-wise issue table with size and quantity
Replacement due date to prevent use of worn PPE
Return or exchange record for reusable gear
Contractor column to track PPE given to vendor workers
Stock summary for reorder planning
Storekeeper and worker signatures

When to use it

Issuing PPE kits to new joiners and contract workers
Replacing worn-out or damaged PPE
Issuing special gear such as full-body harnesses or respirators for specific jobs
Monthly stock reconciliation and budgeting for PPE

How to customise this template

1List your standard PPE items and typical replacement intervals
2Add batch or serial numbers for harnesses and respirators
3Pair with the PPE acknowledgement form for the worker's undertaking
4Set reorder levels in the stock summary
5Decide recovery rules for contractor PPE in vendor contracts

HR tips

Issue PPE free of cost to workers
Check fit, especially safety shoes and respirators
Inspect harnesses before every issue; retire damaged ones
Review usage trends to detect quality problems with a supplier

Employers are generally required to provide suitable PPE free of cost under the OSH Code, 2020 and related rules; verify current requirements for your process and keep issue records.

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Frequently asked questions

Should employers charge workers for PPE?+

PPE should be provided free of cost. Some companies recover the cost of PPE that is deliberately damaged or not returned, as per a clear policy.

How often should safety shoes be replaced?+

It depends on usage and wear; many plants set a standard such as once a year and replace earlier if damaged. Record the due date on the register.

Do contractors' workers get PPE from the principal employer?+

The contract should state who provides PPE; the principal employer must still ensure no one works without suitable PPE on its premises.

All 50 posh, workplace safety & compliance →

[Company Logo][Company Name]
WORKPLACE SAFETY INCIDENT REPORT
Incident No.:
[Reference Number]
Date of Report:
[Date]
Reported by:
[Employee Name], [Designation]
Part 1 – Incident Details
Date of incident [DD/MM/YYYY]
Time
Shift
Location / area / machine
Department
- Fire / smoke / explosion
- Electrical incident
- Chemical / gas / oil leak or spill
- Equipment, vehicle or machine failure
- Structural failure / falling object
- Injury to person (attach injury report)
- Property damage only
- Other: [Details]
Description: what happened, in sequence
Persons involved (name, ID, employee / contractor / visitor)
Witnesses (name, contact)
Part 2 – Immediate Action
Form · Word
Workplace Safety Incident Form
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[Company Logo][Company Name]
COMPLAINT OF SEXUAL HARASSMENT AT THE WORKPLACE
To,
The Presiding Officer
Internal Committee, [Company Name]
[Company Address]
Email: [IC Email Address]

This form is confidential. You may attach additional sheets wherever space is insufficient.
Part A – Complainant Details
Full Name
Employee ID / Contractor / Visitor
Designation
Department
Work Location
Preferred Contact Number
Preferred Email
Best time and way to contact you
Part B – Respondent Details
Name of Respondent
Designation
Department / Organisation
Work Location
Relationship to you (manager, colleague, client, vendor, other)
Part C – Details of the Incident(s)
Form · Word
POSH Complaint Form
Download .docx
[Company Logo][Company Name]
POSH TRAINING FEEDBACK FORM
Session Date:
[DD/MM/YYYY]
Trainer:
[Trainer Name]
Batch / Location:
[Work Location]
Your feedback helps us improve. Writing your name is optional. Please do not use this form to report a complaint; contact the Internal Committee at [IC Email Address] or any committee member instead.
Section A – About You (optional)
Name (optional)
Department
Role level (Staff / Supervisor / Manager)
Employee or contract staff
Section B – Rate the Session (1 = Poor, 5 = Excellent)
Aspect 1 2 3 4 5
Content was clear and easy to understand
Examples were relevant to our workplace
Trainer handled questions well
Duration was appropriate
Language of delivery suited me
Form · Word
POSH Training Feedback Form
Download .docx
[Company Logo][Company Name]
WORKPLACE SAFETY POLICY
Policy No.:
[Reference Number]
Effective Date:
[DD/MM/YYYY]
Version:
[Number]
Owner:
[Safety Officer / Admin Head]
1. Purpose
[Company Name] is committed to providing a safe and healthy workplace and to preventing injuries, ill health and damage to property. This policy sets out the minimum safety standards that apply at all our premises and work activities.
2. Scope
This policy applies to all employees, trainees, contract workers, vendors and visitors at [Work Location] and any other premises, sites or vehicles operated by the company, including client sites where our staff are deployed.
3. Definitions
Policy · Word
Workplace Safety Policy
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[Company Logo][Company Name]
HEALTH & SAFETY CHECKLIST
Premises:
[Work Location]
Checked by:
[Employee Name], [Designation]
Date:
[DD/MM/YYYY]
Period:
[Month / Week]
Fire Safety
- Fire extinguishers in place, pressure gauge in green, refill date valid
- Emergency exits unlocked, unobstructed and signed
- Fire alarm / smoke detectors tested this month
- Evacuation plan displayed on each floor
- No storage of combustible material near electrical panels
Electrical Safety
- No loose wires, damaged plugs or exposed cables
- No overloaded multi-plug sockets or daisy-chained extensions
- Electrical panels closed, labelled, with clear access
- UPS / battery room ventilated and dry
First Aid
Checklist · Word
Health & Safety Checklist
Download .docx
[Company Logo][Company Name]
ACCIDENT REPORT FORM
Report No.:
[Reference Number]
Establishment:
[Company Name], [Work Location]
Date of Report:
[Date]
A. Injured Person
Name
Employee ID / Contractor Name
Designation
Department
Age
Gender
UAN
ESI IP Number (if covered)
Contact Number
Emergency Contact informed (name, time)
B. Accident Details
Date of accident [DD/MM/YYYY]
Time
Shift and hours worked before accident
Exact place
Activity being performed
Machine / tool / vehicle involved
How the accident happened
PPE being worn at the time
C. Injury Details
Form · Word
Accident Report Form
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[Company Logo][Company Name]
SAFETY TRAINING ATTENDANCE SHEET
Site / Plant:
[Work Location]
Date:
[DD/MM/YYYY]
Time / Duration:
[Time] / [Number] minutes
Trainer:
[Trainer Name], [Designation]
Language:
[Hindi / English / Regional]
Training Type
- Toolbox talk
- Safety induction (new joiner / contractor)
- PPE use and care
- Machine-specific / LOTO
- Forklift / material handling
- Chemical handling
- Work at height
- Electrical safety
- Other: [Details]
Topic and Key Points
Topic
Key point 1
Key point 2
Key point 3
Questions raised by workers
Attendance
Register · Word
Safety Training Attendance
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[Company Logo][Company Name]
FIRE SAFETY TRAINING RECORD
Premises:
[Work Location]
Training Date:
[DD/MM/YYYY]
Duration:
[Number] hours
Trainer:
[Trainer Name], [Fire Safety Agency / Fire Officer]
Training Type:
[Awareness / Fire Marshal / Fire Team]
Content Covered
- Causes of fire and fire triangle
- Classes of fire and the right extinguisher for each
- Extinguisher operation using the PASS method
- Hose reel / hydrant operation
- Raising the alarm and calling 101 / 112
- Evacuation routes and assembly point
- Electrical and LPG safety
- Role of fire marshals
Equipment Used in Practical
Type Capacity Quantity Discharged Refill Arranged
ABC dry powder [Number] kg [Number] [Yes / No]
CO2 [Number] kg [Number] [Yes / No]
Water / foam [Number] litres [Number] [Yes / No]
Participant Record
Register · Word
Fire Safety Training Record
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