pickup-return - Teudley-Tech Solutions.

Pickup-Return Form

Request type *

Ticket Number *

Name *

First

Last

Address *

Apt / Suite

City, State, Zip *

First

Middle

Last

Phone Numbers *

Email *

Is the Equipment currently working? *

Equipment Information: Type, Brand name, Serial number and quantity.

Service details /Notes: *

Our Term: *

I'm at least 18 years of age and have the legal rights to give the Technician access to the equipment mentioned above.

Legal *

I will follow the CDC directive on COVID-19 Prevention, including the Social-distancing, face-covering and other related rules imposed by my local government during my engagement with Teudley-Tech Solutions, LLC.

For updates on COVID-19, visit: https://www.cdc.gov/coronavirus/

Name