APANA^® LOAN OF EQUIPMENT FORM

LOAN OF EQUIPMENT OR PROPERTY

I,.....................................................................(insert full name)

of ................................................................(insert full address)

hereby loan to the Australian Public Access Network Association Incorporated (APANA) the following item(s) of equipment:

Description                       Brand/Model                           Serial No.
-------------                         ---------------                             -----------
 
 
 

for the following purpose(s):
 
 

for the period of (insert time or loan dates)
 
 

The aforementioned equipment is in the following condition:
 
 
 
 
 
 
 

Signed    .............................................................................................     (lender)

Dated at .................................. on ......................................................

Witnessed ...........................................................................................
 
 

I, ........................................................................................................(insert full name)

of .......................................................................................................(insert full address)

and representing APANA in the capacity of .........................................* hereby accept the aforementioned equipment on behalf of APANA and cerity that it was in the condition so stated by the lender.
 

Signed    ..............................................................................................(representative of APANA)

Dated at  ..................................  on  ....................................................

Witnessed ............................................................................................