Data Erasure Form

Consent For Data Erasure Form

Please Fill Out Your Personal Information Below


Disclosed Devices

Please list the devices being worked on or repaired by Monolith Solutions in the format of Device Name / Device Model - Serial Number


Data Erasure Policy

When signing this document, you the client consent to the following terms and conditions. Any statements pertaining to YOU, I or MY refer to you the client.


I have backed up any important data and understand that files on my hard drive may be lost during repair. I authorize Monolith Solutions to perform any of the following tasks:

  • Format my hard drive
  • Perform a factory reset on my phone, tablet, mobile or other device
  • Erase data from any device or storage media that I have requested to be erased
  • Dispose of, shred or perform security compliance data destruction as per my request

I understand that Monolith Solutions cannot be held responsible for data or information loss or damage due to repairs.

I also hereby acknowledge that Monolith Solutions Inc. has not supplied any software or product keys for any software program that is not or was not present prior to my device being worked on and that Monolith Solutions Inc. cannot be held responsible for the presence of any data or program found on any computer that they have engaged in working on.

Sign Here
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