Microplus Computer Services Ltd.
Evaluation Request Form

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The following information will help our lab technicians solve your data recovery crisis in as timely a manner as possible. The more information you can provide, the better.
Client Information
Company
Organization
Contact
*required*
Email
*required*
Phone #
*required*		 Ext.  
Fax#
Address
City
Province/State
Country Postal/Zip
Job Details
Media For Recovery Include:

Manufacturer:
Model:          
Serial Number:
Interface Type
SCSI IDE EIDE ST-MFM ST-RLL ESDI Other
Controller:

Computer Type :

Operating System: Other:

Special Partitions or Device Drivers:

Compression: Yes No Describe:
Description of Failure
Circumstances of Failure:



What Recovery Attempts Have been Made:



Please List Specific Files or Folders That Are Most Needed:



Preferred Destination Media: CD ROM Customer Provided Hard Drive Warranty Hard Drive Other- Specify:
Shipping Information
Drive Has Been Shipped To Microplus Computer Services Ltd.: Yes No

Date Sent:

Courier/Shipping Company:

Way Bill or Shipping Number:
Please Verify all information before Submitting your Request.