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Customer Acknowledgement Skip Bin Drop Off

Form to be completed by client / customer

Name
I am,(Required)

Clear Signature
Time & Date Of Submission: {submission_date}
I agree and acknowledge
  • I have requested the SKIP BIN be placed on natured strip/road.
  • If any fines are issued to Greenfields Waste, for the SKIP BIN being placed on nature strip or road, I take FULL responsibility and liability to accept any fines issued.
  • I agreed to pay the fines no later than 7 days after issued.
  • BE AWARE fines may be issued after the SKIP BIN has been collected.
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