MEDECO USE ONLY FAX# 800-421-6615 Card T- MASTER KEY ...

MEDECO USE ONLY FAX# 800-421-6615 MEDECO USE ONLY. Card T- MASTER KEY system Registry #. Cert #- REQUEST/COVER SHEET Keyblank #. Orders may be delayed without Angle/Ref#. complete information (Please print clearly. Use black ball pen or type). Date: Section 1 DISTRIBUTOR LOCKSMITH. MEDECO Account Number _____ MEDECO Account Number _____. Company Name: Company Name: Street Address: Street Address: City, State,Zip: City, State,Zip: # (If applicable) # (If applicable). Section 2 ENDUSER. Organization Name: Street Address: (NO. PO BOXES). City, State,Zip: Phone Number: Contact Name: Type of Business: Section 3 IF CARDED, CARDHOLDER NAMES: ALL CARDS SENT TO: Print or Type Name: Street: City, State, Zip: Section 4 Original Biaxial MEDECO 3 Biaxial BiLevel MEDECO 3 Original Pins: 5 or 6 Interchangeable Core Y or N. Keyway: *Cam/Switch Locks/60 Series Y or N Cross Keying: Y or N. *Note: Cam/Switch Locks cannot be MASTER keyed together with door hardware locks system Specifications (including expansion): (please enter numbers).

The master key system request form was designed to help you provide the information Medeco needs to supply the new master key system your customer needs. Please write legibly in black ink to furnish this information. Date: The date you are mailing or faxing the request form.

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  System, Master, The master key system, Master key, Master key system

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