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Company Information

Business Legal Structure *
PHYSICAL address
I have a different MAILING address *
MAILING address

Principal Owner or Officer
Privacy/Compliance Officer

Billing Contact Information

Accounts Payable Information (where invoice will be sent)

Payment Information

Use Purchase Order *

(if available) Please email a copy of the PO to billing@shredohio.com

Payment Method *

REQUIRED FOR THIS OPTION
You will receive an email with OMS EFT/ACH information or download the info form below, you must set this up through your bank. Confirmation email of setup required, send to sales@shredohio.com, or your direct representative.

REQUIRED FOR THIS OPTION
Provide two vendor/service providers the company regularly does business with. (We can also accept a business reference document if available.)

Service Information

Shredding services to be performed *

*PLEASE NOTE: an appointment is required for this option.

I would like to witness the shredding when I deliver my materials. *

* PLEASE NOTE: a small witnessing fee and limited scheduling availability apply for witness option.

Types of materials to be destroyed *
Does the materials contain any of the following:
Hard Drive Destruction
Are all drives removed from the device? *
Are all drives removed from sleds? *

PLEASE NOTE: our AAA Certification requires the recording of drive serial number into a report. We charge a fee per 200 units. You have the option to Opt-out of this service, but requires filling out an opt-out agreement prior to service.

Would you like to receive the serial number report? *

Service Location

Service address different than PHYSICAL Address? *
You indicated you will be delivering your materials to us.  You can skip this step.

Day of Service Contacts

PRIMARY Contact
SECONDARY Contact
You indicated you will be delivering your materials to us.  You can skip this step.

Location Logistics

Are you available to service during lunch period? *
Have the service rep call ahead before they arrive?

PLEASE NOTE: trucks have a height of 13'-6", low hanging wires and/or trees can affect serviceability. 

Does this location involve any internal/external stairs? *
Does this location have an elevator that is big enough to use? *
You indicated you will be delivering your materials to us.  You can skip this step.

Material Information

Material are contained in: *
Boxes

*PLEASE NOTE: if more than 50 boxes, please send us some pictures to help with making sure we can provide enough space and equipment for removal.

Dock & Skid Pickup
Are you boxes on skids? *
Are the skids shrink wrapped? *
Do we need to bring a pallet jack? *
Are your boxes at a dock? *
Box Conditions
Would you like to keep your boxes? *

*PLEASE NOTE:
With On-site service, we will try to accommodate but, we cannot guarantee box removal due to limited vehicle storage.

*PLEASE NOTE:
With Off-site service, keeping your boxes will incur a small ancillary transfer fee.

Bags
Filing Cabinets
Loose and/or Stacked Materials
Other
Temporary Use Containers
Do you need containers delivered prior to the service day for any loose, non-boxed materials?

*PLEASE NOTE: Temporary use containers are not available for locations with stairs.

Security Receptacle

Security Cart

PLEASE NOTE:
Temporary use containers are not required to use for purge service.
Delivery of temporary use containers are subject to a refundable deposit and delivery fee.

E-Recycling Pickup (Non-destruction)

PLEASE NOTE: we do not accept monitors/televisions (any stand-alone screen), toner/ink cartridges, or any items with refrigerant.

You indicated you will be delivering your materials to us.  You can skip this step.

Final Step

Form completed by
How did you hear about OMS? *