Asset Request Form
Requestor Information
Name :
Email :
Department :
Request Date :
Asset Information:
Asset Type: (Check one) Laptop, Desktop, Tablet, Smartphone, Printer, Scanner, Other (please
specify) :
Asset Number (if applicable) :
Branch :
Reason for Request :
New Asset Request:
Do you need a new asset or is this a replacement?
If replacing an existing asset, please provide the current asset number :
Return Policy:
Will the asset be returned to the IT department when no longer needed? Yes / No
If yes, please provide the expected return date:
Additional Comments:
Is there any additional information you would like to provide about your asset request?
Authorized Signature:
Date: