Data Recovery Center Physical Request Form

Chem-Building No.516
Data Recovery Center
BEIJING NORMAL UNIVERSITY
NO.19,Xinjiekouwai St.Beijing 100875 P.R.China
Phone: 86-10-62672120
Fax: 86-10-62672120
INSTRUCTIONS: Print the form, fill it out, sign, fax us a copy and include the original with the media/equipment you ship.

CONTACT INFORMATION
Company:

 

 Telephone:

 
Address:

 

 

 Fax:

 

 
Contact Names:

 
EMAIL ADDRESS:

 
CREDIT CARD INFORMATION:  (The credit card will not be charged unless the recovery is successful.  We accept Visa, MC, Amex, and Discover)

NUMBER:

EXP:

NAME ON CARD:

BILLING ADDRESS:


 
Price Quoted For Recovery:

 

Customer Care Representative You Spoke With:

Michael, Bill, Justin, Art, Adam,Steve

 

(Please Circle One)
To help us better serve you and our other customers please tell us how you found us:

Search Engine Used:


Term or Phase Used For Search:
 

 

INFORMATION ABOUT MEDIA FOR RECOVERY
What Type of Media: ____ Hard Drive, ____ CD, ____ Jazz, ____ Zip, ____ Tape, ______________________ Other Can we break the seals on the media if necessary?
___ Yes (May Void Warranty of Drive)   ____ No
 
Operating System:

 

 File System If Known:

 
Manufacturer:

 

 Model:

 
Number of Volumes or Partitions On Media:

 

 Serial #:

 
How Much Data Was on the Media?

 

 Purchase Date of Media If Known:

 
What data is the most important for recovery? Folders, Directories, and Files.  (exam. My Documents)

 

 

 

 

 What media should be used to return your data?
(*Drives with over 2gb of data we REQUIRE recovering the data to another hard drive.  You may either supply one or we can supply one to you at a reasonable cost.)
___I wish to buy a hard drive.
(IDE 3.5" 60gb Drive)

___CD ROM*

___The formatted drive I have included

___Other (specify): ____________________________

 

Situation Of Failure
The reason of Failure or In-Accessibility:

 

 
What solutions if any have already been tried on the media:

 

 

 

Shipping Information
Shipping Company Used:

 

 Way Bill # or Tracking Number So We Can Track It: