PICK-UP REGISTRATION FORM
(Monday - Friday, normal business hours)

Dear Customer, we have pick-up service in the Cleveland and Akron Ohio areas. We charge $200.00 per pick-up plus material fees by product type:

1. CRT & LCD Monitors = $9.00 each.
2. Televisions = $0.25 per pound.
3. All other materials, we charge $0.05 per net pound.

Reminder, we will need to have the accounting information for invoicing prior to the pickup. Please complete & submit the form. We will reply back to you promptly!

If you have Full Trailer Loads in other Midwest and East coast locations, contact us at info@itranusa.com and include your location, number of pallets & types of materials.

Thank you for recycling responsibly!

LOCATION INFORMATION:

Company Requesting Pick-Up:*
Pick-Up Requested By:*
Contact Telephone Number:*
Contact Email Address:*
Street Address 1:*
Street Address 2:
City:*
State (Ohio Only):*
Zip:*
PICK-UP DETAILS:
Requested Pick-Up Date:*
Requested Pick-Up Time:*
Equipment Types and Quantities:
Is equipment palletized?*	(Please select a value) Yes No Partially
Is a Certificate of Insurance Necessary to Enter the Building?*	(Please select a value) Yes No
LOCATION DETAILS:
Maximum Size Truck your Location Can Accommodate?*	(Please select a value) 24 45 52
Does This Location Have a Dock?*	(Please select a value) Yes No
What Are the Dock Hours?
Is There a Liftgate Needed?*	(Please select a value) Yes No
Is a Pallet Jack Available?*	(Please select a value) Yes No
Is a Forklift Available?*	(Please select a value) Yes No
Special Instructions: