Take-Back programme




This form is only for the take back of unwanted or end-of-life electrical and electronic equipment.
This information will not be shared with third parties..
* = mandatory field
Customer Details
Company Name*

Pickup Address
Country*
Collection Address*
Contact Person*
Email Address*
1st Telephone Number*
2nd Telephone Number

Services Requested
Collection / Delivery*
Type of service*
Optional extras:
Data Destruction Certificate required*
Serial / asset tracking*
Notes:
1) All self-deliveries have to be pre-booked. Booking details will follow on receipt of order request.
2) If the equipment is in good working order and suitable for reuse / refurbishment please select the "Reuse" option - all equipment will be fully assessed for safety and functionality.
3) If the equipment is not suitable for reuse or you do not wish to participate in the reuse programme, please select the "Recycling" option. A certificate to confirm recycling will be sent.
4) If you do not know the condition of your equipment and have no objections to it being assessed for reuse, please select the "Recycling or reuse" option.
5) All data bearing equipment is wiped prior to reuse / recycling - however, if you require a secure data destruction service, please select "Yes". An additional charge may be made for this service and can include secure destruction of DLT tapes; hard-drives and disks on your own premises or at our secure recycling locations. Each data bearing equipment will be tracked via serial / asset numbers to final destruction.
6) We are able to provide serial number / asset tracking for all / some of your appliances at an additional charge – please provide the details in the box provided (e.g. the types of equipment; number of appliances requiring tracking etc.). If possible provide a spread sheet with the serial / asset number and make / description of appliance – e.g. HGG4555 Sony hard drive as we will be able to use this as a cross reference to check off the appliances on arrival at the recycling centre. Whilst we do check and track all consignments and all items received, this additional service provides a dedicated report confirming the numbers of items received and the serial number / asset number of each individual appliance and confirmation of the date of destruction.

Materials to be Collected
Number of units. Weight in Kg. (use approx weight if not known)
PC's, workstations, servers
Network equipments (hubs, routers)
Laptops
Mixed IT eqpt.(keyboards; mice etc.)
Printers, scanners, all-in-ones
Wide-format plotters
Monitors / televisions / other screens
Cooling eqpt (fridges / air con etc.)
Medical equipment
Commercial catering equipment
Other
(The total weight is only to give us a guide as to the size of vehicle required.)

Collection / Delivery Information
Number of loose boxes / bags *
Number of pallets / cages*
Preferred date(dd/mm/yyyy) & time*
Notes:
1) Items must be presented in a box or plastic liner ready for collection or placed on pallets or into cages and secured for transit. All cables etc. must be taped to the appliance or placed inside the housing.
2) All toners and print cartridges and other waste should be removed prior to collection.
3) Collections are made on weekdays between 8 a.m. and 6 p.m..

If any items for recycling are contaminated (e.g. contaminated with chemicals / bodily fluids) a specialist collection / recycling service may be required.
Contamination Declaration*
Additional Information
Optional file attachment

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