SAMPLE — FOR ILLUSTRATION ONLY

CERTIFICATE OF DATA DESTRUCTION

EWaste Phoenix · R2v3 Certified · NAID AAA · NIST SP 800-88 Rev. 2 Compliant

Certificate #COD-SAMPLE-0001
Date of Destruction[Date]
Client Organization[Client Business Name]
Client Address[Client Business Address]
Project Reference[Project Number]

Device Information

Asset Tag[Asset Tag]
Device TypeHard Disk Drive
Manufacturer / Model[Manufacturer] / [Model]
Serial Number[Serial Number]
Capacity[Capacity]

Destruction Method

Method UsedPhysical Shredding (NIST 800-88 Rev. 2 — Destroy)
Particle Size≤ 2mm
VerificationWitnessed by [Technician Name], Certified Technician
Technician ID[Tech ID]

Chain of Custody

Pickup Date / Time[Date/Time]
Facility Receipt[Date/Time]
TransportGPS-tracked, bonded vehicle
Processing Date[Date/Time]

This certifies that the storage media described above was destroyed in accordance with NIST SP 800-88 Rev. 2 guidelines. All data has been rendered permanently unrecoverable. Service provided to businesses, offices, facilities, and data centers only.

Authorized Signature: ___________________________

Title: Facility Operations Manager

EWaste Phoenix · 1721 W. Rose Garden Ln Suite 3, Phoenix, AZ 85027
(480) 372-5999 · info@ewastephoenix.com