Pager Acknowledgement Form

Revised:  March 28, 2007  

I acknowledge receipt of the following pager for use in conducting business for the Texas Forest Service and the citizens of the State of Texas, and I further understand the use of the pager is limited to official business.  I understand and agree that until the pager has been returned by me to the issuing office, I am responsible at all times for the equipment and all expenses incurred by use of this equipment. 



Print name of employee                                                                                      Office



Signature of employee                                                                                        Date





Pager vendor (Baystar or Metrocall)                                                  I.D. number





Signature of Telecommunications Coordinator                       Date



Return of Pager


I am returning the pager described above.



Signature of employee                                                Date



Signature of Telecommunications Coordinator                       Date



TFS Pur-226  

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