DEVICE CLAIM AFFIDAVIT
Complete this form in its entirety. ecoATM may request additional information to support the claim.
ecoATM Claim Number: C03125532
Device Owner’s Name: CABE TEMPLE
Device Claimant’s Name (if different from Owner):
Owner’s Residence Address: 1304 Meadow Dr. Killeen TX,76549
Mailing Address (no P.O. Box): 1304 Meadow Dr. Killeen TX,76549
Phone Number for Communication: 254-226-9393
Email Address: Cabectemp@gmail.com
Device Make and Model: Samsung S22
IMEI Number: 359670541045164
Serial Number: N/A
Police Report Number (if filed): N/A
You may need to share your personal information, including your government ID image, with ecoATM to verify
device ownership. By doing so, you authorize ecoATM to collect, store, and use your information, including
government ID image, for as long as necessary to prevent fraud, investigate crimes, or comply with applicable laws.
We will not use this information for any undisclosed or unauthorized purposes, nor will we share it with third parties
without your explicit consent, except as required by law or for investigative purposes.
Learn about our data handling at http://www.ecoatm.com/privacy-policy/.
By signing below, I certify that the foregoing is true and correct; and that I am the legal owner of the device and I
have reported said device as missing to law enforcement and/or my wireless carrier. I understand that ecoATM may
share information about my claim to law enforcement in order to prevent fraud and help investigate crimes.
Print Name: CABE TEMPLE
Signature: Date:
Who is ecoATM?
ecoATM operates a nationwide network of automated kiosks that allow consumers to recycle their used personal
electronics. ecoATM kiosks have numerous security features to prevent unauthorized sale of devices; however, on rare
occasions the kiosk will take in a device that is later reported missing. It is our company policy to return such devices to
either the rightful owner or law enforcement, free of charge.
What can I expect if my claim is approved?
Please be aware of the shipping policy: 1) Someone over the age of 21 with valid ID must sign for the package; and
2) Estimated 3-4 business days for delivery; and 3) A tracking number will be emailed when the device has shipped.
If you have questions, please email ecoSupport@ecoATM.com or call (858) 255-4111 during normal business hours
(6 am to 5 pm PT, Monday through Friday).
ecoATM | 10121 Barnes Canyon Rd, San Diego, CA 92121
