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Monday - Friday 9:30-5:30

93 N 2000 W, Pleasant Grove, UT, 84062

taklockservice@gmail.com

801-839-6777

YOUR KEY TO A PEACE OF MIND

REKEY
LOCKOUT
CAR KEY
LOCK REPAIR
OTHER

Acerca de

RESTRICTED KEY REQUEST FORM

Requested by

Email

Request date

Phone #

Party responsible for payment

Billing Email

Billing Phone #

Building Name, Address, and Suite # to needed keys

Select the type of key

Master Key

User Key

Other

Select the type of key

Primus C123

Primus C

Medeco X4

Medeco M3

Platinum

MX

Other

Quantity needed

List any stamps on the keys (numbers and/or letters)

Method of Receving

Pickup

Mail ($10 shipping)

Delivery ($65-$95 service call)

Shipping Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Additional Notes

Your Signature

Do you have a picture of the requested keys?

Upload File

Upload supported file (Max 15MB)

Please note that High Security Patent Restricted Keys can only be obtained through authorized personnel and require a State issued ID to be provided upon receiving.

Thank you for your order!

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