Sample
Hardware and Software Inventory List
Employee’s Name: __________________________________ Date: ______________
Employee’s Bureau/Division/Agency: ______________________________________
Agency Provided Hardware
Hardware Type Serial # Program Version
PC
Monitor
Surge Protector
Printer
Other
Other
Other
Agency Provided Software
Type Serial # Program Version
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Hardware and Software Inventory List
Continued
Employee Provided Hardware and Software
____________________________________ Date: __________________
Employee’s Signature
____________________________________
Employee’s name printed
____________________________________ Date: __________________
Supervisor’s Signature
____________________________________
Supervisor’s name printed
____________________________________ Date: __________________
IT Department Representative's Signature
____________________________________
IT Department Representative’s name printed
2 of 2