Lapy King Laptop Disposal Form

1. Customer Details
3. I am a new customer I am an existing customer
4. First Name(required)
5. Last Name(required)
6. Company Name (if applicable)
7. Address
8. Suburb
9. State
10. Post Code
11. Fixed Line Phone No. (Please include your area code)
12. Mobile Phone No.(required)
13. Email(valid email required)
14. Referred By
15. Laptop Details
16. Brand
17. Toshiba HP Compaq ASUS Dell Acer SONY IBM Lenovo Other
18. Model Name [ ? ]
19. Part Number or Model Number [ ? ]
20. Serial Number [ ? ](required)
21. Password (If no password please enter NONE) [ ? ](required)
22. Included Accessories [ ? ]
23. Fault Description [ ? ]
24. Have you or anyone else accidentally dropped or damaged the laptop?
25. Have you or anyone else accidentally dropped or damaged the laptop?
26. Yes No
27. Have you or anyone else accidentally spilled liquid on the laptop?
28. Have you or anyone else accidentally spilled liquid on the laptop?
29. Yes No
30. Data Instructions
31. Please provide us with instructions regarding your data (data includes programs, documents, photos and any other information stored on the computer). We would carry out a full wipe out of the hard drive once we receive the disposed laptop. All data, information and software will be deleted. It is your responsibility to back up your data to an external device prior to sending the disposed laptop and to retain copies of all software applications installed on your laptop. Alternatively, we could perform a back- up or data recovery service for you for a reasonable fee prior to performing a data wipe out.
33. Please provide me with a quote for back up or data recovery services prior to disposal of the laptop
    My data is fully backed up or is not essential, so it need not be retained – please perform a free of charge data wipe out before disposal of the laptop
    
34. Customer Statements
35. I guarantee Lapy King that I am the rightful owner of the laptop and/or have the rightful authority to transfer full title of the laptop to Lapy King for the purpose of reclamation, refurbishment, resale, destruction, disposal and/or recycling
36. I understand that all transferred laptops will be reformatted and all data, information and software will be deleted and become irrecoverable. I indemnify Lapy King against any claims from this loss and I accept full responsibility for the removal and security of any data, information and software contained on the laptop prior to the transfer to Lapy King.

 

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