PPE Issuance Receipt

Receipt acknowledging issuance of PPE to an employee. Documents what was issued, condition at issuance, and trains-on confirmation. Required for OSHA 29 CFR 1910.132 recordkeeping.

Employee & Issuance Details

• Employee Name
• Employee ID
  Optional if your organization uses an employee ID for recordkeeping.
• Department
• Issue Date
• Issued By
  Name of the supervisor, safety representative, or authorized issuer.

PPE Issued

• PPE Items Issued
• PPE Notes
  Use for serial numbers, model numbers, special fit notes, or exceptions.

Training & Acknowledgement

• Employee confirms they received PPE use and care instructions
  Includes proper use, limitations, maintenance, storage, and when to request replacement.
• Fit / sizing verified where applicable
• Employee had the opportunity to ask questions
• Employee Acknowledgement
  Signature confirms receipt of the listed PPE and understanding of the training provided.
• Issuer Signature