Laboratory Instrument Borrowing Agreement

Borrower Information

Name
Department / Affiliation
Contact Number
Email

Instrument Details

Instrument Name
Instrument ID / Serial No.
Condition

Borrowing Period

Date Borrowed
Date to be Returned
I, the undersigned, agree to take full responsibility for the borrowed instrument listed above. I will ensure proper use, handling, and timely return of the instrument in its original condition. I shall report any damage, loss, or malfunction immediately. I understand that failure to return or loss of the instrument may result in applicable penalties and/or replacement costs.
Borrower Signature
Lab In-charge / Supervisor Signature
Date
Date