Fillable Form 6: Center Use Only Philadelphia Repair Center

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Form 6: Center Use Only Philadelphia Repair Center

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Philadelphia Repair Center
6
Lacrue Avenue, Suite 35
Glen Mills PA, 19342
Phone: (610) 521-6100
Date:
S.O.:
Center Use Only
Billing Address
Shipping Address
Warranty Repair Non-Warranty Repair
Model #:
Serial #:
Your Asset #:
Send only the accessories and disks
necessary to resolve the problem.
Problem Description
Vendor Diagnosed
Self Diagnosed
Other Diagnosed
Admin User: __________________________ Password: ____________________________
Manufacturer’s warranty does not cover shipping, software configuration or virus issues.
It is okay to erase my hard drive(s) and their contents - I have a backup
Please restore my Operating System for $44.95.
Name:_________________________________________
Company: ______________________________________
Address: _______________________________________
City: ____________________ State: __ Zip: __________
Phone: ________________ Cell: __________________
Email: _________________________________________
Name:_______________________________________
Company: ____________________________________
Address: _____________________________________
City: ____________________ State: __ Zip: ________
Recipient Phone: ______________________
Memory: ________MB
HD1: ______GB HD2: ______GB
List other external hardware and CDs/DVDs below:
YES
YES
Cutomer must supply OEM disks
for OS Reload and Application
Reload.
Service & Repair
531-A Conchester Hwy
Boothwyn, PA 19061
610-521-6100
Service & Repair
531-A Conchester Hwy
Boothwyn, PA 19061
610-521-6100
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Form 6: Center Use Only Philadelphia Repair Center

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Completed 29 December 2021

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