Equipment Disposal Form

Equipment Disposal / Donation / Recycling Authorization

Authorize Gem State Paper & Supply Company to dispose, donate, or recycle your equipment. Once processed, equipment cannot be returned.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Company Name
Requested Action
Reason for Disposal / Donation
Equipment Information (add rows for each item)
Customer Signature
Authorization: I certify by this e-signature that I am authorized to act on behalf of the company listed above and authorize Gem State Paper & Supply Company to remove and dispose of, recycle, salvage, or donate the equipment identified on this form. I understand that ownership of the equipment transfers to Gem State Paper & Supply Company upon pickup or receipt and that the equipment may not be recoverable after processing.
Should be Empty:

Equipment Disposal / Donation / Recycling Authorization