City of West Branch
121 North 4^th Street West Branch, MI 48661
(989) 345-0500
(Please print, complete, & return to City Hall at address listed above)
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Equipment Loan Application

Date Borrowed: _____ /_____ /__________

Type of Equipment and Quantity: ____________________________________________

_________________________________________________________________________

_________________________________________________________________________

Company Name: __________________________________________________________

Person Responsible for Returning Equipment: __________________________________

                                                                               __________________________________
                                                                                                         Signature

City Employee Name: ______________________________________________________

Date Returned: _____ /_____ /__________

Returned To: ________________________________________________ (City Employee)