Receipt of Uniforms

Receipt of Uniforms

Use this form to record any uniforms you receive.
YesNo

Today's date and time:*

MonthDayYear
DateHourMinutesAM/PM Option
Which market do you work in?*
You MUST select this in order to see the correct options below.
Name of person RECEIVING uniform items:*

First NameLast Name
Name of Person Issuing These Uniform Items: Enter the name of the individual who provided the items. ***NOTE- If the items were picked up from storage or received without a specific person issuing them (e.g., a shipment or batch pickup), enter: “Remarq Agency.”*

First NameLast Name
ReceivingReturning
Name of person RETURNING or PROVIDING the uniform items:
Email of person RETURNING uniforms
Where do you want a copy of this form emailed to?
Garments MIGHT each have a code handwritten on them with black marker. It's a 3-4 digit combination of numbers and letters which should be near a colored grommet. If no grommet nor code, please add a code in a well-hidden area (under that tag). The code must include your 2 initials and a unique 2-digit number.

Example code: VA11, VA12, VA13, etc.

SHIRTS

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SPORTS SHIRTS

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CAPS

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YesNo

JACKETS - Only Team Leads are authorized to retain 1 jacket for personal use. Management may assign additional jackets to a Team Lead to hold for operational use during shifts; all such jackets remain company property and must be returned upon request. ••• Team Members (non–Team Lead role) may borrow a jacket for use during a shift only and must return it at the end of that shift. Team Members are not permitted to retain jackets beyond the shift under any circumstances.

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Puffer Jackets

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Fleece Jackets

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2023 New style Jackets

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Please submit photos of the code and grommet for each item listed on the form above. The photo should capture the code (and grommet) written on the garment.*

Take photo or select file
You can use this button to UPLOAD photos or to take multiple photos, one at a time. Cancelof
Uniform Responsibility Acknowledgment

I acknowledge receipt of the uniform items listed above. These items are issued to me for use while performing my work assignments and remain the property of the Company.

I agree to maintain these items in my care while they are assigned to me and will not transfer, loan, or allow another employee to retain them without prior written authorization from the Company.

If any item becomes lost, stolen, damaged, or otherwise no longer in my possession, I will notify Staffable in writing within 24 hours of becoming aware of the issue.

Upon separation of employment, or upon request by the Company, I agree to promptly return all assigned uniform items in reasonable condition, except for normal wear and tear.

If assigned items are not returned, or are damaged beyond normal wear and tear due to dishonesty, willful misconduct, or gross negligence, the Company may pursue recovery of replacement costs through lawful means consistent with California law. The Company will not make any deduction from wages except as permitted by applicable law.

Replacement values (for reference only):
• Jacket: $59
• Shirt: $42
• Cap: $28
Signature of person RECEIVING the uniforms item(s)*

Clear
PROVIDER OF UNIFORM ITEM(S)

I confirm that the uniform items listed above were issued to the employee identified on this form on the date indicated and that the information recorded on this form is accurate to the best of my knowledge.
Signature of person PROVIDING the uniform items*

Clear
Date*

MonthDayYear
Date

Only "Regulars" and Team Leads are permitted to keep uniform items. Alternate Team Members must borrow uniform items for the day and return them at the end of the shift to be cleaned. The only exception is if there is advance written approval from management for an Alternate to keep uniform items.
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