Work Authorization Form

Dependable Rooter & Plumbing Work Authorization Form

We request that you complete this Authorization to Perform Work.

Please call us at (916) 238-5848 or use our contact page if you have any questions.

We cannot perform work without prior authorization completed with this form.

Your Name:(Required)

First Last

Your Phone:(Required)

Your Email:(Required)

Address Where Work Will Be Performed:(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

By Signing below, I authorize the work to be completed. ( Your signature is your initials.)(Required)

Please enter your initials.

By entering your initials or entering your name you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge.

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