Data Recovery Service Site Map Data Recovery Form
Print & Fill out for Faster Service - Turn-around 5-7 Days| See Common Questions before calling.
Call us Toll Free 1-866-857-5950

Name/Co: ___________________________
Add: ________________________________
City: __________________ State: _____ Zip: _______ Country: _______
Cell Phone: ________________ Phone 2: ___________ *E-Mail: ___________________________

*Please Print Clearly | Use your PayPal e-mail if possible

File/Media Information - Media Type (Circle one):
USB Drive or Diskette | CD-R/CD-RW/DVD-R/DVD-RW | Tape/Zip Drive | Hard Drive | Other: ________________

1) Media Size/Capacity: ________ MB or GB (circle one) 2) Make & Model (Important): _________________ Computer Make & Model: __________________ 3) Operating System: _______________________
4) Briefly describe the problem (use back of form or separate sheet if necessary):
____________________________________________________________
5) Has the media been formatted? Yes | No

6) Any data written to media after the above problem occured? Yes | No
Please specify any recovery attempts that have already been made:
________________________________________________
Please list crucial data (directories, files, file types, etc.) needed (use back or separate sheet if necessary): ___________________


Pricing Information - No data recovered means No charge. A data recovery fee is charged if ANY data is recovered. Depending on size, recovered data is returned on CD(s) or HD.
*A $20.00 fee is charged for shipping & handling on each order (Include cash when shipping if possible or make check to eProvided.com) Applies to mailed-in media
*$150.00 fee for RUSH order. Fee based on level of recovery (Fees may differ from original quote, Seperate from $20.00 Shipping/Handling fee) Once recovery is complete, info on storage options will be sent.


Don't call/email for status/shipping updates
, we'll notify you per our turn-around time. Recovery is not guaranteed, data may be corrupted past a point of salvation. I understand I'm in no way guaranteed any files will be recovered from supplied media regardless of any expressed/implied comments. I've read eProvided's "Policies, Terms Conditions" link on the eProvided homepage & agree to all terms & conditions. I understand there are recovery & ship/hand/analysis fees. I've read this entire form. I indemnify, defend, & hold harmless eProvided for any & all liability, demands, actions, liens, losses, damages, costs, judgments, & expense, including reasonable attorney's fees arising out of or resulting from any eProvided services. I authorize eProvided to bill me for services rendered if any images are recovered. (We use PayPal or will accept a check/CC's)
How did you find us? (circle/check one)
Friend/Associate
Camera Store (store name): __________________
News/Story - CNN - MSNBC - Popular Mechanics
Trade Magazine___________
Search Engine | Sponsored Search Result (PPC - Sponsored)
Google Yahoo! MSN AllTheWeb
AltaVista AOL AskJeeves IxQuick.Com
Other: _______________________

Payment Request Type: (Please Circle One)
1) Paypal.com --> (Uses Your Visa-MC-AMEX-Discover Card) We Bill if a Success
2) Check ____


Mail this form along with your media to:
eProvided.com
5485 Spur Cross Trail
Parker, CO 80134
Attn: Data Recovery

*eProvided is not responsible for lost media mailed improperly. Protect shipment by wrapping with bubble-wrap or a padded box/envelope. Data recovery can't be guaranteed in all situations, data may be corrupted past a point of salvation. I understand I am in no way guaranteed any data will be recovered from supplied media regardless of any expressed or implied comments. I authorize eProvided to bill me for services rendered if any data is recovered. (We use PayPal.com and accept business or personal checks) 12-24-05 | Recover Digital Picture | Photo Recovery Software | Hard Drive Recovery Software | USB Data Recovery | USB Flash Drive Recovery |

Print Name: ____________________________ Signature: __________________________ Date: ____________