Free Trash Removal Order Form

1. Your Name *
Your Name
2. Your Service Request
3. List Items You Need Removed?
List Items You Need Removed?
4. Is junk Appliance, Vehicle, or Equipment Working?

5. Please Provide Photos Of Items You Want Removed. Photos Will Help Us Serve You Better. (Optional)

1st Photo (Optional)
Upload Picture Of Items (Optional)
2nd Photo (Optional)
Upload Picture Of Items (Optional)
6. Address Where Service Is Requested *
Address Where Service Is Requested
7. City *
City
8. State / Province *
State / Province
9. Zip / Postal Code *
Zip / Postal Code
10. Approximate Date You'll Need Service? *

MM
/
DD
/
YYYY
11. Your Contact Number
Your Contact Number
12. Your Email *
Your Email
13. How Did You Hear About Us? *
14. Add Any Comments Or Notes Here
Comments Or Notes Here

*************** Important Information Please Read Below ****************

All Items must be on the main level and ready to go.
There is a 15 minute time Allotment per location for free pick up and removal of your metal items. Weight for each individual item must not exceed a 100 pounds
All Washers, dryers, dishwashers, refrigerators, microwaves, and stoves must
be detached from any utility hook up, empty, drained, free and clear of all loose content and or debris
(NO EXCEPTIONS) fees will apply for over size items or if above conditions are not met.

---------------------Free Removal For Metal Items Only---------------------------

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800-507-4070
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