Log Request for wipe :
All Fields are Mandatory
First Name Email Address
Last Name Phone #
Company Name
Device Type Service Charge Discount Add Quantity Amount (USD)
Windows Operating System
Desktop, Laptop or All in one PC $85.00
Server $150.00
Tablet $85.00
External Hard Drive $50.00
Old Hard Drive $50.00
Flash or Memory Drive $20.00
Android Operating System
Smartphone $25.00
Tablet $25.00
Total
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