$300 Data Recovery - Hard Drive Destruction Form

$300 Data Recovery's Hard Drive Destruction Form
First Name *
Last Name *
E-mail *

Confirmation Email *DO NOT use @sbcglobal.net or @att.net e-mail addresses (their spam filter will not let our e-mails through).
Phone Number *

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Address

Manufacturer: *
Model: *
Enter device(s) serial number (if unsure, write some unique number from the drive's label): *
Manufacturer:
Model:
Enter device(s) serial number (if unsure, write some unique number from the drive's label):
Manufacturer:
Model:
Enter device(s) serial number (if unsure, write some unique number from the drive's label):
Manufacturer:
Model:
Enter device(s) serial number (if unsure, write some unique number from the drive's label):
Manufacturer:
Model:
Enter device(s) serial number (if unsure, write some unique number from the drive's label):
HARD DRIVE DESTRUCTION TERMS & CONDITIONS (Check ALL to indicate you agree) *

I am the owner of all devices listed. The items listed were delivered to a $300 Data Recovery representative. I am authorized to request destruction of the devices listed. The listed items are intended to be destroyed, and cannot be returned with data intact under any circumstance. $300 Data Recovery will not assume responsibility for sensitive data present on devices collected for destruction. $300 Data Recovery cannot validate that all data has been completely erased from submitted devices. $300 Data Recovery will handle and store all devices submitted for destruction as if it contains sensitive data. Once $300 Data Recovery collects devices, the data on the media should be considered to be destroyed and completely unrecoverable.
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$300 Data Recovery's Hard Drive Destruction Form