Office Use Only: Ticket#:__________________     CR: ____________     Bin: ___     Pin: ___

Data Recovery Request Form
Nekston Associates
Attn: Data Recovery
P. O. Box 360391
Dallas, TX 75336
Phone: (214) 212-4631

Please complete this form, print it out, sign it at the bottom, and include it with your media.

Package your drive as if you were shipping an egg. First place the drive in an anti static bag if you have one. Then wrap the drive in 3 or 4 good layers of bubble wrap and place it in a well fitting box. Make sure you use a shipping service such as UPS or FedEx.

Please remove all mounting brackets, laptop adaptors, mounting screws, etc. from your drive


Contact Information
Company Name:
Contact Name:
Position:
Street Address:
Street Address Line 2:
City:
State:
Zip Code:
Phone:
Fax:
Alternate Phone:
E-Mail:
Website:

Billing Information
Card Type:
Card Number:
Expiration Date:
Name On Card:
Billing Address:
Billing City:
Billing Zip:
In the event your data is not recovered, a $35 charge will incur for return shipping of your drive.
No credit card information is being transmitted across the Internet from this form.

Media Information
Computer Type:
Operating System:
Type of Media:
File System:
 (example: Fat32, NTFS, HFS, etc.)
Hard Drive Manufacturer:
Capacity in Gigabytes:
Model Number:
Serial Number:
Disk Interface:
Number of Volumes or Partitions:
Purchase Date:
Have The Warranty Seals Been Broken?:
Yes    No (This is rare, if Yes, a $175 diagnostic fee may apply)
Can We Break The Seals If Necessary?:
Yes    No
Price Quoted For Recovery:
Plus Tax For Texas Residents
Do You Need This Expedited?:
Yes    No $299 Additional Charge (1-3 Day Turn Around)

Situation of Failure
Does The Drive Make Unusual Noise:
Yes    No   Sometimes
If Yes, What Kind Of Noise:
Is The Drive Seen By BIOS:
Yes    No
Is The Drive Seen By The OS:
Yes    No
What Events Led Up To The Failure:
(Attach Additional Information If Necessary)


Most Important Files & Directories ( be as specific as possible, attach additional pages if necessary)
File Types
File Locations
Specific File Names
.doc, .xls, .qbw, .pst, Quicken, Word
c:\MyDocuments, d:\backup
Archive.pst, salesreview.xls
Select Media For Recovered Data:
Select Desired Return Shipping Method:

Terms & Conditions

The services you are requesting will be performed under the following terms and conditions. This is the complete agreement between you and Nekston Associates, Inc dba Nekston Associates. Nekston Associates must approve any modification to this Service Agreement in writing.

1.You hereby engage Nekston Associates and/or its suppliers to use all commercially reasonable efforts to determine the existence and extent of recoverable data on your media (“Evaluation”) and retrieve and/or provide access to your recoverable data (“Data Recovery”), or to delete data from your media (“Deletion”) (collectively, the 'Engagement')

2. Information contained in your data/media (“Client Information”) will be used by Nekston Associates only for the purpose of fulfilling this Engagement, and will otherwise be held in confidence by Nekston Associates. These confidentiality obligations shall not apply to any information which enters the public domain through no fault of Nekston Associates, which was known to Nekston Associates prior to receipt from you, which is disclosed to Nekston Associates by a third party (other than employees or agents of either party) which to Nekston Associates's knowledge in making such information available to Nekston Associates is not in violation of any confidentiality obligation to you, which is independently developed by Nekston Associates without recourse to the Client Information, or which is used by Nekston Associates in any legal process. You acknowledge that Nekston Associates may keep record copies of its deliverables and the data/media received from you under this Agreement. This confidentiality agreement may be breached by Nekston Associates at any time, when Client Information is found to contain data such as child pornography or information that is detrimental to national security.

3. You will be charged a custom quoted Data Recovery Fee and you agree to be responsible for all media, shipping and handling charges and all risk of loss during shipping, even by Nekston Associates between its offices. You agree to pay all charges quoted, plus shipping charges, as well as taxes and similar charges. No services will be performed and no charges incurred unless you consent by executing this Service Agreement. Additionally, in the event data is deemed unrecoverable, you agree to pay all shipping charges associated with the return of the unrecoverable media to you.

4. You acknowledge that the media/data/equipment you are making available to Nekston Associates is already damaged, that data recovery efforts can result in further damage, and that Nekston Associates is not responsible for this or any other type of damage, including damage to or failures by equipment or media furnished by Nekston Associates.

5. You warrant and represent and warrant to Nekston Associates that you are in lawful possession of all data, media and/or equipment you make available to Nekston Associates, and that you have a lawful purpose to engage Nekston Associates for the Engagement. If you are requesting any Deletion services of any kind whatsoever, you hereby warrant and represent that such data is not involved in any current or anticipated legal proceeding, investigation or government inquiry. You agree to indemnify and hold Nekston Associates harmless from any and all claims, liabilities, costs (including attorneys’ fees) and damages of any kind related to this Service Agreement.

6. You agree that Nekston Associates grants no warranties regarding its services of any kind, and all services are provided on an “as-is” basis. ALL IMPLIED WARRANTIES (INCLUDING THE WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE) ARE DISCLAIMED.

7. NEKSTON ASSOCIATES WILL NOT BE LIABLE FOR ANY DAMAGES WHATSOEVER, WHETHER DIRECT, INDIRECT, INCIDENTAL, CONSEQUENTIAL, SPECIAL, PUNITIVE, OR EXEMPLARY (INCLUDING, WITHOUT LIMITATION DAMAGES FOR LOSS OF BUSINESS PROFITS, BUSINESS INTERRUPTION, LOSS OF BUSINESS INFORMATION OR DATA, AND THE LIKE) ARISING OUT OF THE SERVICES OR DELIVERABLES PROVIDED HEREUNDER, EVEN IF NEKSTON ASSOCIATES HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.

8. Any consent required of either party will be effective if provided in a commercially reasonable manner, which includes without limitation email or facsimile, and/or verbal authorization if followed by written confirmation at the earliest possible opportunity. Nekston Associates will store your data for 10 calendar days after your recovery has been completed. After such 10 calendar day period, Nekston Associates will delete your data.

9. Should your data be deemed completely “Unrecoverable”; or you simply elect not to have your data recovered, shipping charges will remain your responsibility. Unrecoverable” means that there is mechanical failure in the media that precludes access to any data on the media by any means within Nekston Associates's capability. This definition does not apply in cases where 'desired' data is not present.

By signing below, I acknowledge that I have read and understood the above stated Terms and Conditions.

Signature:______________________         Printed Name:_____________________      Date:_________