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Page <br />Customer: Salesperson: <br />Agreement #: Transaction #: <br />Customer ("You") Customer Account:Service Requested: <br />Company: <br />Address: <br />City: County: <br />State: Zip: Phone: <br />Contact name: <br />Email: <br />Alternate Contact: <br />Alternate Phone: <br />If "Buyout Reimbursement" is selected above, the following MUST be completed: <br />To be paid upon delivery / acceptance pursuant to Rider B, Section 1. <br />Payable to: Reason for check issuance: <br />If transaction includes a Lease Upgrade or Buyout the following MUST be completed: <br />Select <br />one: <br />Original Order Date <br />Will retained equipment remain under a CUSA Maintenance Agreement? <br />Trade in Equipment Condition: <br />Equipment for Trade-In, Upgrade, or Return <br />If transaction includes a Lease return the following MUST be completed: <br />Pick Up /Return Information: <br />Hours of Operation: Number of Steps:Elevator: Loading Dock: <br />Special Instructions / Additional Requirements: <br />Customer’s Authorized Signature <br />Printed Name Title Date <br />SLS-900 January 2025 <br />Contact Name: <br />Item Code <br />Leasing company name Lease Number <br />$ <br />Equipment Location Email <br />Alt pick up <br />date <br />Canon U.S.A, Inc. ("CUSA") <br />One Canon Park, Melville, NY 11747 <br />(800)-613-2228 <br />ofTrade in, Upgrade, Return, Buyout Schedule ("Schedule") (SLS-900) <br />Return Schedule, Rider B of Agreement <br />THIS RETURN SCHEDULE IS ENTERED INTO PURSUANT TO, AND INCORPORATES ALL OF THE TERMS OF, THE MASTER SALES AND SERVICES AGREEMENT <br />REFERENCED AS THE AGREEMENT # ABOVE AND THE APPLICABLE RIDER(S) ("AGREEMENT"). BY YOUR SIGNATURE BELOW, YOU AGREE TO TERMS AS <br />SPECIFIED ABOVE, SUBJECT TO THE TERMS AND CONDITIONS OF THE AGREEMENT. CUSTOMER REPRESENTS THAT EXECUTION OF THIS SCHEDULE HAS <br />BEEN DULY AUTHORIZED. YOU REPRESENT THAT YOU ARE AUTHORIZED TO EXECUTE THIS SCHEDULE ON CUSTOMER’S BEHALF. STANDARD TERMS AND <br />CONDITIONS INCORPORATED HEREIN ARE AVAILABLE AT MK1.USA.CANON.COM/CUSTOMERDOCUMENTS, AND SHALL APPLY TO THE EXTENT NOT MODIFIED <br />BY THE AGREEMENT. YOU ACKNOWLEDGE RECEIPT OF A COPY OF THIS RETURN SCHEDULE. <br />Order date: <br />Lease Information (if applicable) <br />Description Serial #Contact Name & <br />Phone <br />Phone: Email: <br />Return <br />code <br />Not Applicable: No Equipment pick up required <br />You will return Equipment to leasing company according to the terms and conditions of your lease agreement <br />You will retain the equipment. <br />Yes: SELECT ONE: under an Existing Contract <br />No <br />Or New Contract <br />CUSA will pick up the Equipment <br />Same Date as Delivery of Listed Items Specified on the Agreement <br />Other Specified Date:_____ / _____ / _____ (but no longer than 30 days after delivery of Listed Items under Agreement <br />Return Equipment to CFS <br />Return Equipment to CUSA <br />Canon Other <br />PO IN LIEU <br />Andrea Morse <br />TRD <br />4 <br />amorse@wsu.eduHRN04688 <br />County of Kittitas <br />WA <br />TRD <br />4 <br />William Thompson <br />MMPA003132 <br />amorse@wsu.edu <br />Andrea Morse (509) 962-7507 <br />Good Working <br />ELLENSBURG <br />901 E 7TH AVE STE 2 EXTENSION SERVICE <br />ELLENSBURG WA 98926 <br />4 <br />1 <br />S21527923 <br />Andrea Morse (509) 962-7507 <br />1 <br />6140B005 <br />Trade In <br />KITTITAS <br />98926 509-962-7507 <br />4802B003 <br />11/21/2025 <br />amorse@wsu.edu <br />901 E 7TH AVE STE 2, WSU EXTENSION SERVICE <br />Canon Other <br />1846609 <br />901 E 7TH AVE STE 2 EXTENSION SERVICE <br />ELLENSBURG WA 98926 <br />County of Kittitas