Account Holder Name
First Name
Last Name
Phone Number
Pick Up Date
-
Month
-
Day
Year
Date
What Product(s) Are We Picking Up?
Washer
Dryer
Washer & Dryer
Gate Code
If applicable
Pick Up Address
Street Address
Apartment or unit number
City
State
Postal / Zip Code
Anything extra you think we need to know?
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Next
Reason For return
Bought my own
Moving away
My new home comes with units
Other
Rate your experience with Quack Rentals
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I ❤️ Quack Rentals!
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