Basic - Precision Computer Recycling Authorization Form

Precision Computer Recycling Authorization Form

 

Owner Information

Owner Full Name: ___________________________________________________________

Address: _________________________________________________________________

City/State/ZIP: ___________________________________________________________

Phone: ______________________________  Email: ______________________________

(Optional) Business/Organization Name: _____________________________________

(Optional) Authorized Signer Title: ________________________________________

 

Description of Items to be Recycled (attach list if needed)

 

[ ] Computer/Desktop  [ ] Laptop  [ ] Monitor  [ ] Printer/Copier/Scanner/Fax

[ ] Phone/Tablet  [ ] Cables/Accessories  [ ] Keyboards/Mice  [ ] Projector

[ ] Server [ ] Networking Gear  [ ] Batteries/UPS  [ ] External/Internal Hard Drives

Other (list any additional items): ________________________________________

 

Ownership and Authority

I, the undersigned Owner (or authorized agent of the Owner), represent and warrant that:

- I am the lawful owner of the listed items or have full legal authority to dispose of them.

- The items are free of liens or third‑party claims unless disclosed in writing.

 

Authorization and Transfer

I authorize Precision Computer to collect, transport, and recycle (and, where applicable, refurbish, resell, dismantle for parts, or otherwise process) the listed items in accordance with applicable laws and industry standards. I hereby transfer all right, title, and interest in the items to Precision Computer upon pickup/drop‑off. Items and components will not be returned; disposition decisions are final.

 

Data-Bearing Devices

I understand items may contain data (e.g., computers, phones, drives). I consent to data destruction procedures used by Precision Computer and release Precision Computer from liability for any data remaining after reasonable, commercially accepted data destruction practices.

 

Hazardous/Prohibited Materials

I confirm the items do not contain prohibited or hazardous materials except as disclosed in writing. Precision Computer may refuse any item at its discretion.

 

Release and Indemnity

To the fullest extent allowed by law, I release and hold harmless Precision Computer, its employees, and agents from claims arising out of the removal, transport, processing, or recycling of the items, and I waive and disclaim any and all damages of any kind (including direct, indirect, incidental, consequential, special, exemplary, or punitive damages) arising from or related to the items after transfer, the services provided, or any disposition decisions, except to the extent caused by Precision Computer’s willful misconduct or gross negligence.

 

Compliance and Records

Precision Computer will handle items in compliance with applicable laws and may use certified downstream recyclers. Certificates of recycling or data destruction (if requested and offered) will be provided after processing.

 

Signatures

Owner/Authorized Agent (print): ____________________________________________

Signature: ....................................................................    Date: ___/___/____

 

If signing for a business, Title: ___________________________________________

Accepted by Precision Computer Representative (print): _________________

Signature: ....................................................................    Date: ___/___/____