Accurate Data Recovery - Evaluation Form

Accurate Data Recovery
18 Hurndale Ave
Toronto, Ont., Canada
Toll Free: 1-888 241 3282

AEvaluation Form

1 - Complete the following online form.
2 - Click the "print" button on your browser to print this form.
3 - Click the "submit" button at the bottom of this page to e-mail us your information.
4 - Sign the printed form and package it with your drive for shipment.
5 - Please follow the Shipping Insructions given at the bottom of this form, or see our Shipping page.

ACompleting the Form - * indicates required fields.


Company Name:		Email: *

Contact Name: *		Position:
Phone Number: *		Fax Number:

Street Address: *

City: *		Country: *
State/Province: *		Zip/Postal: *
Please try to fill in as much detail as possible:
Type of computer:		Make/Model:

Operating System (example - Windows XP):

Hard Disk, Make/Model: *

Capacity Gb:

Serial Number:

Is the Drive under Warranty? Yes No

Disk Interface: SATA ATA100 IDE Enhanced IDE SCSI

Other:

Compression: None Double Space Stacker

Other:

Compression Software Version (ex.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:


AWhere did you hear about our company?


Search Engines	Yahoo Yahoo Sponsored Results Google Google Sponsored Results MSN ASK AOL Comcast HotBot WebCrawler DogPile

Referred by: name and email address

Other Sources (Directory, newspaper ad, magazine, promotional email, etc.)

Tell us what KEYWORD you searched under to find us:

A Shipping Information

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 8471.70.10.13 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 package 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.

ATerms 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 Data Recovery.

AStep 2: Print out the form and sign

AStep 3:


Accurate Data Recovery 18 Hurndale Ave Toronto, Ont., Canada, M4K 1R7	Tel.: 416-465 4103 Fax: 416-465 7223 Toll Free: 1-888 241 3282	Customer Support: adata@accurate-datarecovery.com Web Address: www.accurate-datarecovery.com