Riverside    (951) 248-1200
Burbank    (818) 842-3667
Signal Hill/Long Beach    (562) 427-7250
 
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Release Request Form

( * ) - a required field
DATE: * TIME:
CUSTOMER NAME: * ACCOUNT #:
JOB
(NAME and ADDRESS): *
ATTN : PHONE #: *
DATE NEEDED: FAX #:
 
* IF THIS RELEASE HAS BEEN REQUESTED BY ANY OF THE FOLLOWING VOUCHER COMPANY PLEASE MARK:

OTHER:
ATTN: FAX #:
 
TYPE OF RELEASES : ( PLEASE MARK ):



THROUGH DATE :  (REQUIRED FOR #1 & #2)
 
NOTE: If you are requesting a conditional progress AND/OR a conditional final AND the balance is zero (0), you will be issued the appropriate UNCONDITIONAL release form.
 
IF THE JOB IS NEW AND YOU HAVE NOT SUBMITTED PRELIMINARY INFORMATION PLEASE FAX OVER WITH THE RELEASE REQUEST.
(PRELIMINARY INFORMATION IS REQUIRED TO COMPLETE ALL RELEASE REQUESTS)
 
DO YOU NEED THE MAKER OF THE CHECK TO BE FILLED IN ON RELEASE FORM ?

IF YES, PLEASE GIVE US THE NAME:
 
DOES YOUR COMPANY NEED TO BE A PAYEE ON THE CHECK ( TWO PARTY CHECK)

DOES YOUR RELEASE NEED TO BE NOTARIZED?

Please keep this form for future reference. If you need a new form, we will issue a new form.

RENO HARDWARE RELEASE DEPARTMENT
FAX: ( 951 ) 248 - 1212
EMAIL: Release@RenoHardware.com
24 HOURS A DAY 7 DAYS A WEEK

REV 6/20/2000




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