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Computer Repair Intake Form For Personal Machines(2)

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Computer Repair Intake Form For Personal Machines(2)
Shared by: ps94506
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posted:
11/30/2011
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Quality Office, Inc.

Service Information Form

Completion of this form is required for service.





*REQUIRED ITEMS* Please bring the required items listed below.

Power Adapters, Any discs provided by Apple, Peripherals (if involved in the experienced problem).







Owner’s Name:___________________________________________ Contact Name: __________________________________

Date & Time: ____________________________________________________________





Address:_______________________________________________ City/ZIP: __________________________________________





E-Mail: ________________________________________________ Phone#: __________________________________________





Login Password (This is the same password requested when installing some software): ____________________________





Type of equipment: desktop computer laptop computer monitor printer other _______





Initial Equipment/software checked in with item(s): ____________________________________________________

here:

____________________________________________________________________________________

____________________________________________________________________________________





Description of problem or work to be done: (please be as detailed as possible. Lack of detail could result in a denial of

warranty service from Apple if no problem is found) ______________________________________________________________









*If necessary, may we delete all files (data and software programs) in order to re-install the

operating system and make the computer functional again?

yes no (If 'no', customer will be contacted first if the procedure is required)

Initial Notice: Customers are responsible for their own data. We take no responsibility for data loss. When possible, personal data

here: backup will be attempted to the best of our abilities with no guarantees.. If we are required to perform a full system backup

prior to work being performed, it may result in a fee of $24.95 to cover the cost of labor. Data backup is not

covered under the warranty terms.

Initial In the event of a system software restoration, Quality Office, Inc. is only responsible for the reinstallation of the original Apple

here: provided software under terms of warranty. Third party applications may be reinstalled under the cost of labor at Customer's

request @ $10 per title when coupled with a warranty repair or approved repair estimate.







Initial Any items left over 45 days from the date of the repair will be considered abandoned and sold to cover any expenses accrued

here: by Quality Office, Inc.









Initial If the device must be checked in for diagnostic, a minimum $59.95 diagnostic fee will be charged. If the device is covered

Here: under an Apple warranty, the fee will be waived for covered repairs. For non-covered repairs the fee will be waived upon

repair estimate approval.









Customer Signature:______________________________________________________________________________________





Receiving Employee:______________________________________________________________________________________

Quality Office, Inc.

Service Information Form

Completion of this form is required for service.







This section is for office use only

____________________________________________________________________________________



Manufacturer’s Warranty: yes no Warranty/APP Dates: Start_________ End_________

Equipment under AppleCare Protection: yes no





Device Info:

Full Model Name: _____________________________________________

Serial Number: _____________________________________________

OS Ver: ____________

iLIfe Ver: ___________

MLB Config: ______________

Memory: ____________ HDD: _________





Description of Problems Observed:









(No charges will be made if Apple Warranty or APP covers the completed repair.)





Estimate: $



Associate:______________________ Customer Approval: ______________________

(Signature) (Signature)



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