Consumer Electronics Destruction Certification Form
Document and certify the destruction of consumer electronic devices in accordance with compliance requirements.
Device Type
*
Please Select
Laptop
Smartphone
Tablet
Desktop Computer
Printer
External Drive
Other
Device Brand
*
Device Model
*
Serial Number or Unique Identifier
*
Quantity Destroyed
*
Destruction Method
*
Please Select
Physical Shredding
Degaussing
Crushing
Data Wiping
Other
Date of Destruction
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Destruction Location
*
Name of Responsible Person
*
Submit Certification
Should be Empty: