The information entered here is NOT transmitted online. This data recovery service form is to be printed.
Please complete, print, sign and include this form in the box with your hard drive. Ship to the address below:
 


Advanced Computing Solutions, Inc.
5036 Dr. Phillips Blvd, #187
Orlando, FL  32819

Phone #: 877-840-3282   Fax #: 407-370-9480

1.

CONTACT INFO

 
Contact Person:
Company Name:
Phone #: ext.    Cell Phone #:
Address:
City:    State:   Zip:
E-Mail Address:


2.

EVALUATION SERVICE TYPE*

 

Please select your requested evaluation service type from the drop down box below.

*Service fee may apply for drives that have previously been opened.
For preferred service, please call for reservation # to enter here


3.

PAYMENT INFORMATION

 
Payment Type:
Name On Card:
Credit Card #:    Exp. Date   CCV*
*Credit Card Verification (For Visa, M/C, & Discover, the last three digits on back of card on the signature line. For AMEX, the 4 digits on the front of the card above the card number.)
Check if billing address is the same as entered above. If not, please enter below.
Billing Address:
City:    State:   Zip:


4.

HOW DID YOU HEAR ABOUT US?

 


5.

MEDIA STORAGE PREFERENCE

 
Type of media you would like your data copied to?  
 


6.

DATA INFORMATION

 
Manufacturer of drive: Model #:
Number of partitions/drive letters: How much data is on the drive:
Is there an operating system on the drive?
How is the drive formatted?

Please briefly describe below what happened when the failure occurred:

Did the drive stop spinning?      Any abnormal sounds? (ex: clicking, etc.)
Any recovery attempts made on this drive?    If yes, please describe below:

IMPORTANT:
Please list the most important files, folders, and/or file extensions in order of importance from first to last below. (Example: My Documents)


7.

TERMS AND CONDITIONS

 

Customer engages Advanced Computing Solutions, Inc ("ACS, Inc") and/or its partners or subcontractors to: inspect, evaluate, and identify the problem (if not already identified); and/or retrieve, or minimize the damage to, the equipment/data/media; and/or provide other services as may be requested by Customer from time to time. Customer agrees to pay ACS, Inc all sums authorized from time to time by Customer, which will typically include charges for ACS, Inc services, reasonable travel and per diem expenses for on-site work, shipping and insurance (both ways), and actual expenses, if any, for parts, media, and/or off-the-shelf software used in the Engagement. Unless otherwise agreed to in advance by ACS, Inc, all such sums are due and payable in advance, by company check, bank money order, or credit card. Customer agrees that an NSF fee may apply for any checks that are returned. Customer acknowledges that the equipment/data/media may be damaged prior to ACS, Inc receipt, and Customer further acknowledges that the efforts of ACS, Inc to complete the Engagement may result in the destruction of or further damage to the equipment/data/media. ACS, Inc regrets that it will not assume responsibility for additional damage that may occur to the Customer's equipment/data/media during ACS, Inc efforts to complete the Engagement. Customer agrees that any equipment sent in for evaluation will be considered the property of ACS, Inc if not claimed within 60 days of the last contact attempt. NO WARRANTIES; DISCLAIMER OF ALL WARRANTIES. ACS, INC, MAKES AND CUSTOMER RECEIVES NO WARRANTIES OR CONDITIONS FOR ANY GOOD OR SERVICE, EXPRESS, IMPLIED, STATUTORY, OR IN ANY COMMUNICATION WITH CUSTOMER, AND ACS, INC SPECIFICALLY DISCLAIMS ANY IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE, AND ARISING FROM USAGE OF TRADE OR COURSE OF DEALING OR PERFORMANCE. In no event will ACS, Inc be liable for any indirect damages whatsoever. ACS, Inc will not be held liable for any damages due to any virus, worm, Trojan horse, etc. The total liability of ACS, Inc to Customer under this Agreement shall in no event exceed the total sums paid by Customer to ACS, Inc. Customer warrants to ACS, Inc that it is the owner of, and/or has the right to be in possession of, all equipment/data/media furnished to ACS, Inc; and Customer will defend, at its expense, indemnify, and hold ACS, Inc harmless against any damages or expenses that may occur (including reasonable attorneys’ fees), and pay any cost, damages, or attorneys’ fees awarded against ACS, Inc resulting from Customer’s breach of this section.

I agree to the above terms and conditions and authorize Advanced Computing Solutions, Inc to charge the card listed on this form, or promise to pay with approved method of payment as indicated, for any priority fees, service fees and/or fees charged for this data recovery service.

Approved by (PrintName):_____________________________________________________

  Signature: _______________________________________________ Date:_____________ 

 

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