Personal Computer Repair Request

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					This Personal Computer Repair Request form is used by computer repair service
providers and their customers when repairing a computer. This document contains the
essential information for the repair service to fix the problem including a description of
the problem, computer specifications, customer contact information, and payment
details. This form should be completed when the customer drops off the computer to
have a record of the transaction. It should be used by companies that repair computers
and their customers.
                        Personal Computer Repair Request

Date of Request: ________________

Requesting Party:__________________________________

General Description of Computer Problem:

______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

Computer Information:

Make: _____________________________ Model: ________________________

Operating System: ________________________________________________

Is the computer under warranty: [   ]   Yes   [   ]   No

Contact Information:

Name: ____________________________________________________________

Address: __________________________________________________________

Phone: ___________________________________________________________

Email: ___________________________________________________________

Payment Method:

[   ]   Cash

[   ]   Credit Card

Amount Due in Advance of Repairs: $__________________

The undersigned Customer agrees to the terms above.



________________________                Date: ____________________________
(Signature of Customer)
(Printed Name of Customer)

				
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Description: This Personal Computer Repair Request form is used by computer repair service providers and their customers when repairing a computer. This document contains the essential information for the repair service to fix the problem including a description of the problem, computer specifications, customer contact information, and payment details. This form should be completed when the customer drops off the computer to have a record of the transaction. It should be used by companies that repair computers and their customers.