First Name

 

Last Name

  

Address

  

City

  

State

     Zip 

Contact #

 

Contact #

  

Email Address

  
Manufacturer
& Model #		  
Carrier  
ESN / IMEI  
Lock Code  

Shipment Items
Phone Charger
Battery Headset
Sim Card     Mem Card

 CHECK ALL THAT APPLY
No power                  No Signal             Not Charging              LCD Damaged              Rapid battery drain 
Cannot hear             Keypad             Headset jack            Cannot be heard           Water damage 
Broken housing       Faceplate          Side Buttons            SIM Card error              Locked
Antenna                  Camera                  Cosmetic                      Powering Off                 Broken in Half

REPAIR REQUEST DETAIL
                                                          

Cell Phone Technicians is committed to quality workmanship. We will work diligently to meet or exceed your expectations. The first step is to provide clear guidelines on the repair process. I understand: Cell Phone Technicians will not be held responsible for abandoned property. I forfeit all rights to the property as well as any compensation for it after 30 days of service. Cell Phone Technicians is not held responsible for programmed user information (i.e. phonebooks, pictures & messages) which may be lost due to damaged equipment. Not all repairs are eligible for the 30-Day Service Guarantee (Ex. Liquid Exposure). Cell Phone Technicians can not be held responsible for transit times during shipping

SHIP TO: 11545 Busy St. Richmond Virginia 23236
 

Signature ________________________________________         Date        /          /
                           We Require Your Signature Authorization To Service Your Phone.