Device Buyback Agreement

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Customer

Bank

Device

Sign

Full Name *

Phone *

Email *

Residential Address *

ID Type (Licence / Passport) *

ID Number *

Account Holder Name *

Bank Name *

Bank Account Number *

Brand *

Model *

Storage *

IMEI / Serial Number *

Device Condition *

EXCELLENT

GOOD

FAIR

POOR

I confirm I am the legal owner of this device and authorized to sell it to SmartGear NZ.

Draw Digital Signature *

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