Cisco Investment Protection

Certificate of Destruction Form

Contact Information

First Name*
Last Name / Surname*
Address 1*
Address 2
City*
State / Province*
Email Address*
Date Destroyed (MM/DD/YYYY)*

Product Information

Product Part Number	Quantity

  I attest that on the above date we destroyed the trade-in products listed above in accordance with local E-Waste guidelines. 

By clicking the submit button you certify to Cisco that the statement above is true.

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