Delivery Slip - Prismatic Technology

Handover checklist

Device collection record

Complete this with staff before the device leaves. Confirm the release details, record the condition and sign the collection record.

Device collection

Check the device with staff, confirm the result, then sign.

Repair ticket / invoice number *

Person collecting *

Customer email *

A copy of the signed collection record will be emailed here. Check the address before signing.

Collecting as *

Collection condition *

Functional test result *

Check physical condition, the repaired function, power/charging, display/touch/buttons and other applicable features. Record anything not working or not tested.

Tested, no issues noticedExceptions noted

Exceptions / checks not completed *

I confirm that I personally inspected this device and completed the applicable functional checks with staff before accepting it. The result and any exceptions recorded above accurately describe what I observed at handover. I confirm receipt of this device.

Receipt only. No functional test confirmed.

I confirm receipt of this device as an authorised bearer for the owner. This is receipt only: I am not confirming a functional test.

Reassembly incomplete · full functional test not completed

Do not power on or use the device until a qualified technician has made it safe.

Device condition and parts handed over / retained *

Owner’s early-release approval reference *

Staff must verify the owner specifically authorised early release. A reference alone is not proof of approval.

I requested collection without allowing the 24-hour reassembly period and chose not to wait. I accept the device in the unassembled or partly assembled condition described above, with the recorded parts handed over or retained. I understand that reassembly and final functional testing are incomplete and that the device must not be powered on or used until a qualified technician has made it safe. I accept responsibility for additional damage caused after handover by handling, transport, use or third-party reassembly arising from that incomplete condition.

I am specifically authorised by the owner to request collection without allowing the 24-hour reassembly period, as referenced above. I accept the device in the unassembled or partly assembled condition described above, with the recorded parts handed over or retained. I understand that reassembly and final functional testing are incomplete and that the device must not be powered on or used until a qualified technician has made it safe. Under the owner’s recorded authorisation, I acknowledge the owner’s acceptance of responsibility for additional damage caused after handover by handling, transport, use or third-party reassembly arising from that incomplete condition.

I confirm receipt of the device in the unassembled or partly assembled condition and with the parts recorded above, for the owner whose early-release authorisation is referenced above. I am collecting only and am not confirming functional testing or making the owner’s early-release decision. I understand that the device must not be powered on or used until a qualified technician has made it safe.

Device condition photos

Add one clear photo of the front and one of the back of the device at handover. Avoid showing passcodes or personal screen content. JPG, PNG or WebP, up to 2 MB per photo.

Front of device

Back of device

This record does not exclude responsibility for loss or damage caused by Prismatic Technology, or limit rights that cannot lawfully be excluded.

Collector signature *

Complete the details and confirmation above to sign.

Submission date and time are included in the staff record.