Sell Your Equipment Form

Sell Your Equipment

Please include as much details and relevant information about the item(s) to help us correctly handle your request.
Date*

MonthDayYear
Company Name*
Contact Name*

First NameLast Name
Department / Position*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address*
Street Address
Street Address Line 2 - (Suite, Unit, P.O. Box, Building, etc.)
City
State
Zip Code

Product(s) To Be Sold

Please include as much details and relevant information about the item(s) to help us correctly handle your request.

	Product Type	Manufacturer	Model	Serial No.	Condition	Issues
Item 1
Item 2
Item 3
Item 4
Item 5
Item 6
Item 7
Item 8
Item 9
Item 10

Additional Information
If you have any special instructions or requirements, please explain in detail.

Signature of Release

I hereby verify that the submitted information is correct and I am have the authorization to sell these item(s). I also verify that the products have been decontaminated.
Additional Information

If you have any additional information, pictures, screenshots. please attach here. You can attach up to (10) files.
Cancelof
Signature*

Clear
Date*

MonthDayYear
Should be Empty: