Return Extractor

    Date Returned:

    Condition on pickup:

    Condition on return:

    Please enter the Number of days In your possesion
    @ $5.00 per day:

    This is a 2 step process. Select Submit button first. Then go to the yellow Pay Now button.

    If Extractor was used 5 or more days, please enter amount owed in Other Amount box.

    Other Amount: USD