Is an electronic signature valid?

Yes in most cases: electronic signatures are legally recognized under the ESIGN Act (15 U.S.C. ch. 96) and by UETA in 49 states and DC, subject to limited statutory exceptions for certain documents.

When is notarization required?

Notarization is not typically required for an Equipment Usage Statement, but specific industries or jurisdictions may require it; check state notary rules and any contract provisions that reference notarized acceptance.

Can I use remote online notarization (RON)?

Possibly — many states permit RON but rules vary. Confirm the recipient's state allows RON and that identity-proofing and recording requirements are met.

How do I correct a signed statement?

If a material error exists, create an amendment signed by the same parties or complete a new statement referencing the original; do not alter a signed copy without clear amendment language.

Who must sign the statement?

The assignee (user), an approving manager or asset owner, and any additional company signatory required by internal policy should sign to demonstrate acceptance and authorization.

How long must I keep the record?

Retain the executed statement for the active assignment and at least three years after return for general recordkeeping; longer retention may apply where IRS or HIPAA rules apply.

Electronic Signature
Templates
Miscellaneous
Equipment Usage Statement

Equipment Usage Statement

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

EQUIPMENT USAGE STATEMENT

This Equipment Usage Statement (Statement) is entered into as of by and between:

Parties

Provider Name Provider Address Recipient Name Recipient Address

Recitals

WHEREAS, Provider owns and maintains the equipment described below and is willing to permit limited use of such equipment under the terms and conditions set forth herein; and

WHEREAS, Recipient requires use of the equipment for the purpose described in the Scope of Use and agrees to comply with operational, maintenance, and payment obligations established in this Statement; and

WHEREAS, the parties intend for this Statement to allocate risk, define permitted use and return conditions, and establish payment and termination procedures.

Equipment Details

Equipment to be used (complete one row per separate item). Additional items may be attached as an addendum and incorporated by reference.

Item 1 — Description / Model / Serial

Item 2 — Description / Model / Serial

Additional Equipment / Attachments

Scope of Use

Provider hereby authorizes Recipient to use the equipment solely for the purposes described below and subject to the operational restrictions and maintenance obligations set forth in this Statement.

Describe permitted use, location, and operating limitations

Payment Terms

Recipient shall pay Provider in accordance with the following schedule. All amounts are payable in lawful currency and must be received within the stated period.

Usage Fee (per period or flat) Payment Schedule Security Deposit Late Payment Fee

Term and Termination

This Statement commences on and, unless earlier terminated in accordance with this Statement, expires on .

Termination Notice Period (days)

Either party may terminate this Statement for material breach if the breaching party fails to cure within the notice period specified above. Provider may also terminate immediately for equipment misuse or uninsured loss.

Confidentiality

Each party shall keep confidential all non-public business, technical and operational information disclosed in connection with the use of the equipment. Confidential information shall not be used or disclosed except as necessary to perform obligations under this Statement or as required by law. The obligations in this clause survive termination for a period of three years.

Insurance, Damage and Liability

Recipient shall, at its expense, maintain insurance adequate to cover loss, theft and liability arising from use of the equipment and shall provide proof of such insurance upon request. Recipient is responsible for repair or replacement costs for damage beyond normal wear and tear. Provider's liability for any claim arising from this Statement shall be limited to direct damages not exceeding the amounts actually paid by Recipient under this Statement during the three months preceding the claim. In no event shall Provider be liable for consequential or punitive damages.

Governing Law

This Statement shall be governed by and construed in accordance with the laws of without regard to conflict of law principles.

Entire Agreement

This Statement, together with any attachments or addenda signed by both parties, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements and understandings, whether written or oral.

Acknowledgements and Certifications

Recipient certifies that it has inspected the equipment and accepts it in the condition noted above unless otherwise documented in writing. Recipient further certifies that all operators are trained and authorized to use the equipment and will comply with manufacturer's instructions and applicable safety laws.

Condition at Delivery Confirmed Confirmed by Recipient
Recipient agrees to perform routine maintenance as specified in the Scope of Use

Any modifications to this Statement must be in writing and signed by authorized representatives of both parties.

Provider:

By:

Date:

Recipient:

By:

Date:

What an Equipment Usage Statement Is and when it applies

An Equipment Usage Statement documents the assignment, permitted use, and responsibilities associated with company or leased equipment provided to an employee, contractor, or third party. It typically describes the equipment, serial or asset numbers, authorized user, permitted locations, usage limits, maintenance and return obligations, insurance and liability allocation, and the effective and termination dates. Organizations use the statement to reduce ambiguity about custody and to create a clear record for asset tracking, insurance claims, loss prevention, and internal compliance reviews.

Why the Equipment Usage Statement matters for risk and asset control

A clear written statement reduces disputes, supports loss recovery, and documents who is accountable for damage, theft, or misuse. It also provides a record for audits, insurance claims, and internal controls without changing the underlying equipment ownership or lease terms.

Typical users and approvers of an Equipment Usage Statement

Departments and roles that commonly prepare or sign this document vary by organization and purpose.

IT and asset managers who assign hardware and track serial numbers for inventory control and warranty purposes.
HR and people managers issuing equipment for remote work, onboarding, or temporary assignments to employees and contractors.
Project managers and supervisors for short-term equipment loans on job sites or client locations.

Signers should include the equipment custodian, the authorized user, and an approving manager or authorized company representative.

Step-by-step: complete and execute the Equipment Usage Statement

Follow these steps in order to reduce errors and ensure that the statement is enforceable and auditable.

01

Prepare document: Populate equipment and party details before routing for signature.
02

Confirm identity: Verify the recipient's legal name and contact information.
03

Obtain approvals: Collect manager or asset-owner approval signatures.
04

Record and store: Save executed copy in the asset registry and personnel file.

Typical routing and processing flow for this statement

A standardized routing flow reduces delays and creates a reliable audit trail for who received and approved the equipment.

Initiator: Uploads statement and selects equipment from inventory.
Approver: Approving manager reviews and signs for authorization.
Recipient: Assignee reviews, accepts terms, and signs.
Records: Completed form stored in asset and HR systems.

Digital workflow settings to configure for reliable processing

Configure the digital routing before sending to ensure authentication, field validation, and record retention align with policy.

Field	Configuration
Required fields	Make serial, assignee, and signature mandatory.
Authentication	Use email or SMS verification for signer identity.
Notifications	Enable reminder emails for unsigned documents.
Retention	Archive executed copies to the asset registry automatically.

Preparing documents for electronic execution and storage

Electronic execution requires correct file formats, signer authentication, and secure storage settings.

File types: PDF or DOCX preferred for fidelity
Integrations: Connect to asset registry or HR system
Accessibility: Enable mobile and desktop signing

Verify that your eSignature platform supports audit trails, exportable signed PDFs, and the integrations your organization uses.

Common timing expectations and internal deadlines

Set explicit due dates to avoid asset loss, policy breaches, or insurance complications.

Assignment timing:

Complete statement before equipment is released to the user.

Return deadline:

Specify a firm return date or clear event condition.

Annual review:

Reconfirm assignments at least annually for inventory accuracy.

Incident reporting:

Require damage or theft reports within 48–72 hours of discovery.

Policy update:

Notify users 30 days before substantive policy changes.

Milestone timeline from issuance to closeout

Track the statement through predefined stages to ensure completion and record retention.

01

Stage 1 — Issue

Document prepared and authorized by asset owner.

02

Stage 2 — Handover

Equipment released after recipient signs.

03

Stage 3 — Active use

Assignee uses equipment under stated restrictions.

04

Stage 4 — Return/Closeout

Equipment returned, condition recorded, form archived.

Common mistakes to avoid when preparing the statement

Omitting serial or asset numbers, which obstructs tracking and warranty claims.
Leaving ambiguous return conditions, leading to disputes about timing and responsibility.
Failing to specify permitted uses, increasing risk of accidental policy violations.
Not retaining signed copies in the asset registry or personnel record for audits.

Security and compliance controls to protect the statement

Encryption in transit: TLS 1.2 / 1.3

Encryption at rest: AES-256

Audit trail: Timestamped signature logs

HIPAA readiness: BAA available where required

Authentication: Email, SMS, or stronger methods

Certifications: SOC 2 Type II and ISO 27001

Consequences of incomplete or inaccurate statements

Loss recovery: Insurance claims may be denied without clear assignment

Liability exposure: Organization may face damage or injury claims

Contract disputes: Ambiguous terms can trigger litigation risk

Operational delays: Missing documentation delays asset redeployment

Policy noncompliance: Violations may breach vendor or grant terms

Regulatory risk: Sector-specific rules (e.g., HIPAA) increase exposure

Essential elements to include in a professional Equipment Usage Statement

Include these six elements to make the statement complete, enforceable, and easy to reference for audits and operational teams.

Parties

Identify the assigning organization and the individual or entity receiving the equipment, with full legal names and contact information for both parties.

Equipment details

List make, model, serial or asset identification number, and any accessories included so the exact items are unambiguous for inventory and warranty purposes.

Permitted use

Describe allowed activities, locations, and prohibited behaviors to protect the asset and maintain compliance with corporate policy or contractual obligations.

Term and return

Specify an effective date, an end date or triggering event for return, and the condition expected when the equipment is returned.

Responsibility

Cover maintenance, reporting obligations for loss or damage, insurance responsibilities, and cost allocation for repairs or replacement.

Signatures

Provide signature blocks for the assignee, an approving manager, and, where required, a witness or notary to document consent and acceptance.

Realistic examples that show how the statement is used

Two concise scenarios illustrate typical use and the operational benefits of a clear Equipment Usage Statement.

Site Equipment Loan

A contractor borrows surveying gear for a three-week project and signs a statement detailing serial numbers and permitted sites

The form requires project manager approval and return receipt
On return the equipment is inspected, condition noted, charges applied for damage, and the completed statement is filed with the project record.

Remote Work Laptop

An employee receives a company laptop for hybrid work and signs for custody and acceptable-use restrictions

The statement lists software licensing, remote access rules, and expected maintenance
The device is tracked in the IT asset register, returned at termination, and the statement becomes part of the personnel separation package.

How an Equipment Usage Statement differs from related document types

Compare this statement to similar forms to avoid duplicating or omitting contractual protections.

Criteria	Equipment Usage Statement	Lease Agreement
Purpose	assignment and use	transfer of possession and rental terms
Duration	short or task-based	typically longer-term
Liability detail	user responsibilities specified	often broader less granular
Signatures	user + approver	parties + possible guarantor

Vendor pricing and capability snapshot for eSignature when using this statement

Select a signing platform that supports the required authentication, audit trail, and retention. Pricing and feature availability differ by vendor and plan; confirm directly with vendors.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	Varies	Varies	Varies	Varies
Bulk Send	Yes (Premium tier)	Varies	Varies	Yes	Varies
Audit Trail	Yes	Yes	Yes	Yes	Yes
Envelope Cap	No cap	100 envelopes/user/year	Varies	Varies	Varies

Frequently asked questions about Equipment Usage Statements

Answers to common questions about validity, signatures, notarization, corrections, and retention for this statement.

Need help? Contact support

Is an electronic signature valid?
Yes in most cases: electronic signatures are legally recognized under the ESIGN Act (15 U.S.C. ch. 96) and by UETA in 49 states and DC, subject to limited statutory exceptions for certain documents.
When is notarization required?
Notarization is not typically required for an Equipment Usage Statement, but specific industries or jurisdictions may require it; check state notary rules and any contract provisions that reference notarized acceptance.
Can I use remote online notarization (RON)?
Possibly — many states permit RON but rules vary. Confirm the recipient's state allows RON and that identity-proofing and recording requirements are met.
How do I correct a signed statement?
If a material error exists, create an amendment signed by the same parties or complete a new statement referencing the original; do not alter a signed copy without clear amendment language.
Who must sign the statement?
The assignee (user), an approving manager or asset owner, and any additional company signatory required by internal policy should sign to demonstrate acceptance and authorization.
How long must I keep the record?
Retain the executed statement for the active assignment and at least three years after return for general recordkeeping; longer retention may apply where IRS or HIPAA rules apply.

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