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ITS and UVa logos for printed output

Video Over IP Encoder Service

Haivision Barracuda Sign-out Form

Please print this page, fill out the Borrower section and bring it along when you pick up the loaner equipment.

Borrower

_________________________________
Signature

_________________________________
Print Name

_________________________________
Department

_________________________________
Estimated Return Date/Time

ITS Use

_________________________________
Serial Number

_________________________________
Signed out by

_________________________________
Date

_________________________________
Return Date

  Page Updated: 2012-09-18