Authorization For Security or Emergency Services
I hereby certify that I have the authority to order the lock, key, safe and security services indicated below. Further I agree to indemnify and hold harmless the locksmith who bears this authorization from any and all liability or claims that may arise from the performance of such services.
Email address *
First & Last Name *
Your answer
Phone number *
Your answer
Identification Number *
Your answer
Service Address
Service Address
Your answer
City/State/Zip
Your answer
Phone number
Your answer
SERVICES PERFORMED *
Your answer
Signing this document holds the signer (Individual or Business) liable for payment.
Signature *
Your answer
Security and Hardware Solutions
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google.