Extractor Return

Total rental fee owed: Your Name (required) Your Email (required) Date Returned: Condition on pickup: Condition on return: Please enter the Number of days In your possession @ $5.00 per day: Deposit check number on file: Any damage requiring the deposit to be cashed? If yes, describe and estimate cost: Deposit outcome: Returned/shredded — no damageCashed in full — $100 damage or moreCashed partial — describe amount above Treasurer initials (deposit resolved):