PERMISSION TO SCRAP INVENTORY FORM 
          
          
         From time to time, we are asked to scrap customers' inventory in our facility, after it has been 
         determined mutually that it is not worth the shipping cost to return it to the owner. 
          
         While we understand the need to save on shipping costs on unneeded inventory, we must request 
         that verbal "scrap requests" be formalized in writing.  
          
         We have identified the inventory below for your convenience, and will scrap it upon the receipt of 
         this signed form. 
          
          
         Customer  
         Location  
         Contact for this form     
         Our original Job #        
         Spindle Identification    
         Serial Number             
         Shipper #                 
           
          
          
         Other Notes and comments: 
          
          
          
          
          
          
          
         Permission to scrap the inventory as described above is hereby granted: 
         Signature:  
         Name: (please print)           
         Date:  
          
         Fax or email back to: 
         Wayne Domke, Operations Manager 
         wdomke@dynospindles.com 
         Fax:  847.680.8838