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Data Recovery Shipping Form

Packing and Shipping Your Hard Drive:

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.
Fill out the form below and include it in your package

Media Type: Harddrive and other storage devices RAID

Contact Information

* Name:

Company:

* Address:

* City:

* State:

* Zip:

* Phone:

- - ex:

Alt Phone:

- - ex:

Fax:

- -

* E-mail:

	Media Device Information

	Harddrive Brand:
	Disk Size:		MB GB TB
	Number of Partitions:
	Operating System:
	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:

	Please send your media devices along with a printed version of this form to : Konicom, Inc. 1819 J Street Sacramento, CA 95811 You must read the Terms & Conditions below before summitting your form:
	I agree with the terms and conditions stated above.
	Note: *Required Fields

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