CACC Form 101 Special Equipment RecordTemporary Hand Receipt 2026

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The document is a Special Equipment Record/Temporary Hand Receipt that outlines an individual's responsibility for the maintenance and safekeeping of issued items. It requires the individual to sign and date the receipt, indicating their commitment to return or pay for any lost items. Instructions for filling out the form are provided, including how to record quantities and indicate zero amounts.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your last name, first name, and middle initial in the designated fields at the top of the form.
In the 'SPECIAL EQUIPMENT' section, list each item you are responsible for. Ensure that entries are made in ink, except for size or rank which should be in pencil.
For each item, indicate the quantity possessed. If you have zero of an item, use a forward slash (/) to denote this and connect consecutive zero quantities with a vertical line.
Advance all totals to the next column if there are any changes in item quantities.
Finally, sign and date the form at the bottom to confirm your responsibility for the items listed.

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