Phone: 800 344-6430 Fax to: (630) 851-5641

PALLET PICK UP REQUEST

Company Name: ________________________________ Date: ____________

Address: __________________________________________________________

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City: _____________________ State:________ Zip:____________

Phone: ( ) ____________________ Fax: ( ) ___________________

Contact Name: ________________________________________________________

Number of Pallets Available for Pick Up:________________

Date Requested for Pick Up: _________________________ Time:____________

Is a pick up appointment required? Yes  No 

Comments: ___________________________________________________________

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