IIT Mandi iHub & HCI Foundation

Section 8 Not-for-Profit Company

Technology Innovation Hub (TIH) in Human-Computer Interaction (HCI)

Regd. Office: Indian Institute of Technology Mandi, VPO Kamand, Mandi, Himachal Pradesh, India - 175075

Declaration Regarding the Issued Items

Name: Affiliation: Permanent Address: Purpose: Mobile No:

Sr. No.	Item Name	Date of Issue	Date of Return	Serial Number of the Item	Action
1

Usage Charges for IIT Mandi Members - ₹1500 per hour

Usage Charges for Non-IIT Mandi Affiliated Members - ₹3000 per hour

I hereby declare that the equipment details of which given above are available to me. I verified that the condition of the product was good before handing it to me during my inspections.
I also declare that I will send prior intimation to IIT Mandi iHub and HCI Foundation whenever the equipment is not available for any reason.
I also declare that I will be responsible for the above-mentioned equipment and any damage to the equipment will be borne by me only.
I also declare that I will return the above-mentioned item in good working condition to the IIT Mandi iHub and HCI Foundation office before I leave the company or as requested by the company.