NC State University
Equipment Tracking Home/Portable Use Authorization Form CA-

Statistics

Donald Martin
Name of User ________________________________
Work Phone ____________________
Dell Laptop
Description of Equipment ________________________________
CAMS Tag# ___________

Department __________________________________ OUC __________________________

Use Type:

☐ Home

☐ Portable

☐ Other ____________________________

Justification for home/portable use

Dell Lattitude  - SN: CDK

When no longer needed

To be returned: ☐ Annual renewal ☐ Date _______________ ☐ Other ______________________
User Signature _____________________________________

//

Date ___________________

Approved By

Terry Byron

Signature ______________________ Print Name ______________________

Title ☐ Dean

☐ Director

☐ Department Head

//

Date ______________

Systems Administrator

☐ Other _______________________________

☐ CAMS system updated to “H”

Complete Upon Return of Equipment
☐ The equipment listed above has been returned

Return Date __________________

User Signature _____________________________________

Date ___________________

Verified by (signature) ____________________________________

Date _____________________

Title ☐ Dean

☐ Director

☐ Department Head

☐ Other _______________________________

Instructions for Initial Authorization: Complete the top portion of the form and save for departmental
files CAMS coordinator should update the online CAMS system to reflect “Home Use” as the condition
code of the asset
Instructions for Return: Complete the bottom portion of the form CAMS coordinator should update the
condition code of the asset using the online CAMS system Retain this form for departmental files
Form CA- (revised )