Accurate Data Recovery
Contact Person: _________________________ Position: _________________________
Phone:________________________ Fax: ______________________________
City: ____________________________ State/Prov: _____________________
Country:______________________ Zip/Postal Code: _____________________
Please try to fill in as much detail as possible.
Type of Computer: _____________________________________
Operating System Version (example: Windows XP):_______________________________
Unix / Novel admin name: ____________________ Password: ______________________
Number of Partitions or Volumes: ________ Volume Names: ________________________
Model:__________________________ Capacity Mb: _____________
Backup Software:________________________ Password: ________________
Make/Model:_____________________ Capacity Gb: ____________________
Serial Number:______________________ Is Drive under warranty: Yes [ ], No [ ]
Disk Interface: SATA [ ], Fibre [ ], IDE [
], Enhanced IDE [ ], SCSI [ ]
Compression: None [ ], Double space [ ],
Stacker [ ]
Compression software version (example: V7.0):_________________________
Detail events leading up to your
disk/tape failure ( noises heard etc.):
Does the computer see the drive: Yes [ ], No [ ]
List files and directories most needed:
Where did you hear about our company?
Yahoo [ ] Yahoo paid add [ ] Google [ ] Google paid add [ ]
ASK [ ] AOL [ ] Comcast [ ] MSN [ ]
Others Sources: (newspaper, magazines, word of mouth, etc.) _______________________
Tell us what KEYWORD you searched under to find us _____________________________
It is very important to fill out the air waybill form (shipping document) correctly in order to avoid any delays in processing your disk through customs.
Please indicate that the contents are a "Computer disk for data recovery repair only. Non-functioning". The harmonized code is 84126.96.36.199
The value for Customs should only be $10.00 in order to minimize any delays for taxes or duties payable.
If you are sending the parcel by Ground Service please ensure that custom brokerage charges are paid by the sender. Accurate Data Recovery will not pay for Customs clearance on inbound shipments.
Terms of Agreement
I, the undersigned have legitimate rights to this data storage device and the data stored on it. I authorize Accurate Data Recovery determine if data recovery is possible and provide an estimate of the recovery costs.
Approved, authorized by: Name (please print):_________________________________
Signature of authorized:_________________________________ Date:____________
Once completed please
put this form in the box with the disk and fax the shippers tracking number to Accurate
(c) Accurate Data Recovery 1998. Copy Rights Reserved.