Green Recycling / Decommissioning Services Questionnaire

The completed questionnaire will enable our team to prepare an accurate, complete and free quotation for service. Though most Green E-Waste Services are free, hard drive shredding included, there may be instances where a fee is assessed.

Please complete your company information below (billable information)

Company Name

First Name

Last Name

Address 1

Address 2

City

State

Zip Code

Phone

Is the company name or billable address different than the client that will be serviced?

Yes

Email Address

Equipment Origin Project Addresses & Project Information

Equipment ORIGIN Street Address

Address Line 2

City

State

ZIP Code

Enter secondary equipment origin or multiple origins here.

Is the service date for this project within the next two weeks?

What is the service date being requested? (MM - DD - YYYY)
- -

Project inventory (manual entry), you can upload inventory or files associated with the project in the field below.

Please attach any file or inventory for the project. <FILE ONE>