Merchandise Check-Out Form

Download printable Merchandise Check-out Form here.

Personal Information:

Name:

Address:

City:

State:

Zip:

Home Phone:

Alternate Phone:

E-Mail Address:

Merchandise Items Checked Out:

Item Name                                         Number                   Value                       Total Value
1.
2.
3.
4.
5.
6.
7.
8.

I certify that I have checked out the above Inventory items from BEHS. I understand that I am responsible for these items for such time as these items are checked out in my name. I understand that when I sell any of the items I check out that I am responsible for submitting those payments within fourteen days. If I resign my position with BEHS, I agree to return the checked out items within seven days or pay the above list value for the item(s). If I give away, damage, destroy or lose any of the above items, I agree to pay the above listed value within fourteen days for those items.

_________________________

Signature

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Date