Customer Information Date: * Business Name: Name: * Address: City: E-mail Address: * State: Zip: Home Phone: Work Phone: Fax Number: How did you find us? Internet Search EngineReferralOther When is the best time to contact you? Morning Afternoon Evening What is the best means to contact you? Phone E-mail Fax Message: Manufacturer * Model Number * Serial Number * Operating System * Drive Capacity * No. of Partitions: * FAT. NTFS? etc. * Failure Information Describe the failure & events leading up to the failure, including any noises * What recovery attempts have been made? For example: SCANDISK, Reformatted, Software tools, etc. * What information or files is the most important to the recovery? * Please detail any passwords that will be needed to open files. These passwords are needed to verify the integrity of the files. * Data is normally returned on DVD-R. If the amount of data is over 20GB or you wish to use a different vehicle for the return of your data, choose one of the following options. Pulkin Computers will contact you for pre-approval of any associated costs. If you expect a large amount of data and want to avoid the hard drive fee, include a drive that has equal or grater capacity for the drive being recovered. * Hard drive (user supplied, formatted) Hard drive supplied by Pulkin Computers (fee) Other Return Shipping Address If different than the customer information stated above Return Shipping Name Return Shipping Company Return Shipping Address Return Shipping City, State, Zip Return Shipping Telephone Service Level Choice & Evaluation Authorization Standard Service ($95.00 X # of drives) Applies toward final recovery cost Standard Service Payment Type VISA Master Card American Express Company Check Pre-approved PO Standard Payment - Name as it appears on card Standard Payment - Card/Check/PO# Standard Payment - Expiration Date Standard Payment - Amount Standard Payment - Today's Date Standard Payment - Authorized Signature Optional Services - Expedited Service ($500.00) We begin work on your system immediately, with dedicated resources, during normal business hours, until completed Optional Services - Emergency Service ($1500.00) Prior arrangement required for emergency service - call for availability. We work around the clock until completion (including nights and weekends) Optional Services - Payment Type VISA Master Card American Express Company Check Pre-approved PO Optional Services - Name as it appears on card Optional Services - Card/Check/PO# Optional Services - Expiration Date Optional Services - Amount Optional Services - Today's Date Optional Services - Authorized Signature Terms and Conditions The services you are requesting will be performed under the following terms and conditions. This is the complete agreement between you and Pulkin Computers. Pulkin Computers must approve any modification to this service agreement in writing.   1) Pulkin Computers will use its proprietary data recovery procedures and leading edge data recovery technologies, as well as the best available commercial efforts, to determine the existence and extent of recoverable data on your storage device (Evaluation).  Pulkin Computers will then retrieve and/or provide access to your recoverable data (Data Recovery).   2) Pulkin Computers will keep all data retrieved from your storage device confidential, and shall not discuss, share, or use any information recovered with third parties. A copy of your recovered data may be kept by Pulkin Computers for a period not to exceed seven (7) business days, in case your return storage device is damaged or lost in transit, after which the data will be deleted from Pulkin Computers storage devices, and Pulkin Computers storage devices will be wiped clean.   3) You will be charged a custom-quoted Data Recovery Services Fee, which includes any applicable non-refundable   Evaluation Fees. 4) No services are performed and no charges are incurred without your consent, and you agree to pay for all authorized work.   5) You agree to be responsible for all storage devices, media, or equipment shipped, as well as for any data loss that could occur during shipping, whether you pay for shipping charges or Pulkin Computers pays the shipping charges.   6) You represent to Pulkin Computers that you are in lawful possession of any data, storage devices, and/or equipment made available to Pulkin Computers, and that you have a lawful purpose to request Pulkin Computers services.   7) You understand that the storage devices, media, and/or equipment you are making available to Pulkin Computers is already damaged, that data recovery efforts can result in further damage, and that Pulkin Computers is not responsible for this or any other type of damage.   8) You understand that Pulkin Computers does not offer guarantees or warranties of any kind, and that the extent of any Pulkin Computers liability to you is strictly limited to the fees you pay Pulkin Computers for its services in this matter.   9) Any consent required of either party will be effective if provided in a commercially reasonable manner, which includes without limitation facsimile (fax), and/or verbal authorization if followed by written confirmation at the earliest possible opportunity. Terms and Conditions - Authorized Signature * Required Privacy Notice

 

copyright 2006 Pulkin Computers Inc.     webmaster: www.mystiqdesgins.com