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COMPANY NAME PAYROLL DEDUCTIONS Items Entrusted To Employee I understand that the company may entrust me with company-provided items when deemed necessary. These items may include cell phones, tools, equipment, vehicles, catalogs, credit cards, uniforms or any other items. I agree that I will use these items in a proper manner and will not abuse them. I will return them to the company in the same condition I received them allowing for normal use. Should I fail to do so, I agree to allow the company to deduct those items or the cost of their repair from my paycheck. Should I leave the company for any reason without returning such items or without resolving such damages, I agree to allow the company to deduct these items from any money due me. ITEMS RECEIVED : $VALUE ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _______________________________ _________ Employee Signature Date Personnel File