Data Recovery Shipping Form

Packing and Shipping Your Hard Drive

1. Proper packing will preserve the condition of your hard drive. The media must not sustain any sort of damage, or the chances of recovering your data will diminish.

If possible, wrap the media in an anti-static material.
Pack the media in a weatherproof box larger than the size of the media, using foam, bubble or any anti-shock / vibration material to surround it. Make sure the drive is secured inside the box to avoid damage due to mishandling

2. Fill out the form below and include it in your package. If you are shipping multiple drives, please create a separate shipping label for each drive and mail them in with your package.

Media Type:

Hard drive and other storage devices RAID

Contact Information

Note: * Required Fields

Name:*

Company:

Address:*

City:*

State:*

Zip:*

Phone:*

- - ex:

Alt Phone:

- - ex:

Fax:

- -

E-mail:*

(xxxxx@xxxxxxxxx.xxx)

Partner Reference Number:

Media Device Information

Hard drive Brand:

Disk Size:

GB TB

Number of Partitions:

Operating System:

List files and directories to be recovered:

RAID Media Device Information

RAID Type:

Other:

RAID Controller Type:

Drive Status:

Provide details leading up to the RAID errors, details of any attempt to recover the data yourself, and the results from your recovery attemps:

Authorization

Please send your media devices along with a printed version of this form to :

Konicom, Inc.
225 N. Barranca Street Suite #125
West Covina, CA 91791

You must read the Terms & Conditions below before submitting your form:

I do not agree to the Terms and Conditions
I agree to the Terms and Conditions

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Your Data Recovery Status:

Customer ID #

Work Order #