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Company Name *

Primary Contact *

First

Last

Email *

Phone Number *

Contact Preference *

Email Phone

Industry *

Number of sites depositing currency *

Approximate average dollar amount of currency deposits per month *

Currency deposited to local bank branch *

Yes No

If yes, number of branch deposits per week *

1 2 Over 2

If yes, number of different banking relationships *

1 2 Over 2

Currency picked up by armored carrier *

Yes No

If yes, number of pickups per week *

1 2 Over 2

Current Carrier *

If yes, does your carrier provide currency and coin delivery? *

Yes No

Have you ever tried smart safes? *

Yes No

Would you be interested in a risk free trial of SafeDeposit service? *

Yes No

Please let us know if you have any additional comments or questions *

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SafeDeposit, Inc.
210 Delburg St
Davidson, NC 28036
980-213-0133