EMPLOYEE LOCKER ACCOUNTABILITY FORM
Document: Employee Locker Accountability Form
Document Version: 7
This is to acknowledge that I Mr./Ms.
with Employee Number whose signature appears below has received one (1)
unit of locker with the following details
ACCOUNT:
IMMEDIATE SUPERVISOR:
LOCKER NUMBER:
By affixing my signature, I hereby acknowledge that I have been issued with the above locker in good working
condition and that I am fully aware of the Locker Policies & Guidelines that I need to strictly abide with. As an
employee, I am responsible & accountable for any damage/misuse of my assigned locker unit and any
violation of the policies & guidelines would be dealt with accordingly based on the Alorica Employee Code of
Conduct for Improper Use of Company Owned Properties and other applicable Policies.
I undertake to comply with the following Padlock Requirements:
1. To Use a Heavy Duty Type of Padlock (Hook must be 4-5mm Thick)
2. Not to Use a Combination Type of Padlock
3. Not to share my assigned locker to anyone
I am fully aware that lockers are part of company properties and understand that the assigned locker is only a
privilege extended to me. I acknowledge that it is my responsibility to ensure the safety & security of all my
personal belongings stored inside the locker and any item lost will be on my own accountability.
It is hereby agreed and understood that failure to vacate and surrender the assigned locker unit upon my
discontinuance from employment will give the company the right to forcibly open the locker after 5 business
days from date of separation.
I voluntary release the company from any liabilities and waive my rights from any claim arising from the forced
opening of the locker unit assigned to me during my employment and upon due notice. Hence, the item/s I
would not claim within 30 days or 1 month upon date locker is forcibly opened, would then be disposed by
Admin Department thru donation to different NGOs, government hospitals or foundations or similar
establishments.
This accountability form is signed and executed this (M/D/Y).
Employee Name:
Employee Signature:
Noted & Received By:
FACILITIES’ COPY
EMPLOYEE LOCKER ACCOUNTABILITY FORM
Document: Employee Locker Accountability Form
Document Version: 7
This is to acknowledge that I Mr./Ms.
with Employee Number whose signature appears below has received one (1)
unit of locker with the following details
ACCOUNT:
IMMEDIATE SUPERVISOR:
LOCKER NUMBER:
By affixing my signature, I hereby acknowledge that I have been issued with the above locker in good working
condition and that I am fully aware of the Locker Policies & Guidelines that I need to strictly abide with. As an
employee, I am responsible & accountable for any damage/misuse of my assigned locker unit and any
violation of the policies & guidelines would be dealt with accordingly based on the Alorica Employee Code of
Conduct for Improper Use of Company Owned Properties and other applicable Policies.
I undertake to comply with the following Padlock Requirements:
1. To Use a Heavy Duty Type of Padlock (Hook must be 4-5mm Thick)
2. Not to Use a Combination Type of Padlock
3. Not to share my assigned locker to anyone
I am fully aware that lockers are part of company properties and understand that the assigned locker is only a
privilege extended to me. I acknowledge that it is my responsibility to ensure the safety & security of all my
personal belongings stored inside the locker and any item lost will be on my own accountability.
It is hereby agreed and understood that failure to vacate and surrender the assigned locker unit upon my
discontinuance from employment will give the company the right to forcibly open the locker after 5 business
days from date of separation.
I voluntary release the company from any liabilities and waive my rights from any claim arising from the forced
opening of the locker unit assigned to me during my employment and upon due notice. Hence, the item/s I
would not claim within 30 days or 1 month upon date locker is forcibly opened, would then be disposed by
Admin Department thru donation to different NGOs, government hospitals or foundations or similar
establishments.
This accountability form is signed and executed this (M/D/Y).
Employee Name:
Employee Signature:
Noted & Received By:
FACILITIES’ COPY
