Phone Handover Form

 

Name of Receiver……………………………………………………………….

ID Proof Type/ID Proof No. of Receiver……………………………………………./…………………………………………………….

IEMI No………………………………………………… Battery No……………………………………………………….

 

I receive the Nokia 2730 phone along with the charger for the use of protocols on the field and will return it back after completion of the pilot project. I take the responsibility of the proper use of the phone and charger for the time period of the pilot.

 

Date of receiving…………………………………. ……………………………………………………..

Signature of Receiver

 

 

…………………………………………………………………

Signature of Field Coordinator (CARE India)

 

 

 

………………………………………………………………… …………………………………………………………

Signature of MOIC Signature of BHM