Toter Pro Claim Form
Company Name
Customer Number
First Name
Last Name
Phone Number
Email
Address
City
State
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
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Mississippi
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Montana
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Ohio
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South Carolina
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Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
Virgin Island
Northern Mariana Islands
Guam
American Samoa
Palau
Postal Code
Issue Description
Product Details
Date of Purchase
Date Out of Service
Product Type
Please select...
Caster/Two-Wheel Cart
Atlas Can
Cube Truck
Tilt Truck
Mobile Truck
Slimline Container
Litter Container
Toter Box
Plastic FEL Container
Organic FEL Container
Lifter
Model
Serial Number(s)
Quantity
Description of Damage
Please add images of the damage for each item requested.
Images
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