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Equipment Lending Form

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Gallaudet University LOAN #: ____________

Graduate School and Professional Programs


EQUIPMENT LENDING FORM Fiscal Year:__________

Note and Agreement of Obligations for Computer-Related Equipment Use

Occasionally GSPP property may be loaned to Gallaudet University faculty and staff in support of research and other scholarly
activities. Any personnel requesting equipment loans must complete this form.

(The following undertaking may be waived at the discretion of the Dean of the Graduate School and Professional Programs or the
Director of the Gallaudet Research Institute, if the application is considered to be inappropriate due to the circumstance of the loan.)

I hereby acknowledge receipt on loan of the equipment from Gallaudet University’s Graduate School and Professional Programs
(GSPP) to be used in support of research and other scholarly activities. In consideration thereof this loan, I agree that:

a) I have inspected the item and it appears to be in working order;


b) I understand the method of operation of the item and shall not try to avoid liability for damage on the grounds of not being familiar with
operational procedures;
c) I shall ensure that the equipment borrowed is not used by a third party;
d) I undertake to return the equipment borrowed in good condition on or before the anticipated return date but also agree that the equipment
borrowed may be requested to be returned early;
e) I accept full responsibility for the transport both from and to the University of the equipment borrowed and agree that the University is not
responsible for this;
f) I shall immediately advise the person in charge of the equipment in the GSPP when I become aware of any damage to or loss of the item or any
part of it.
g) If the period of the loan extends beyond six months, either within this initial agreement or subsequent extensions, I shall make the equipment
available, in a manner as directed by the GSPP and at intervals of not more than six months, to a member of the GSPP to check the existence
and condition of the items;
h) I will use the equipment only for the business of the University;

i) I agree to accept complete responsibility for the condition, care and custody of the item until it is returned and, in particular, I agree to pay the
cost of any necessary repairs to or replacement of the item if it or any part of it is damaged.

Equipment borrowed:

Vendor, make and model #:


Gallaudet ID #:
Other information:

Today’s date: _____________________ Anticipated return date: ____________________________

Signature and department of borrower: __________________________________________________________________________

Printed name of borrower: ____________________________________________________________________________________

Reason for loan: o Priority Research Grant o Small Grant o Other __________________________________

Signature of GSPP Dean or GRI Director: _________________________________________________________________________

Loaned out by (GSPP staff name): _______________________________________________________________________________

Returned equipment received by (GSPP staff name): ________________________________________________________________

Condition of equipment returned: _______________________________________________________________________________

Date equipment returned: _____________________________ Form: SJK, 6/01

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