Collect My Computer LAPTOP, PC CUSTOMER SIDE COLLECTION FORM Date In: MM slash DD slash YYYY Time : Hours Minutes AM PM CONTACT INFOName(Required) First Last Email(Required) Business Name: ADDRESSAddress(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PASSWORDS / SECURITY CODESUser Profile Name: User Profile Password EQUIPMENT & PROBLEM INFORMATIONEquipment Type:(Required) LAPTOP or PCModel:(Required) Serial Number: If available. Often found at the bottom of your machineFault Description:(Required)ACCESORIESAC Adapter Yes No Power Cord: Yes No VGA Cable: Yes No DVI Cable: Yes No HDMI Cable: Yes No Bag/Pouch: Yes No Other Accessories:EQUIPMENT CONDITIONPhysical Condition: Scratches LCD Cracked/Broken LCD Scratched Minor Broken Parts Major Broken Parts Other:T's & C'sTerms of Trading : 1)14 Day warranty on labour. Full manufacturers warranty on parts standard terms is 1 year parts and labour warranty for assembled systems, 1 year parts warranty for component sale, all are return-to-base warranty, or cost of R35 for onsite pick up and return. 2) Unless otherwise specified in writing, terms are strictly C.O.D., Cash, Credit Card or Cheque to be paid on completion of service call. 3) Customers are requested to be in attendance at the premises until a consultant arrives and until the job is completed. 4) Warranty is void if the warranty label has been tampered with. Warranty goods must be supplied with original invoice. Warranty covers the HARDWARE supplied by The Iconeeronly. Problems caused by SOFTWARE (operating systems and application programs) are NOT covered by warranty. Problems caused by software may be fixed at a expense to the customer. Whilst the upmost care is taken when working on PCs’ The Iconeerwill not take any responsibility for any files, data lost during the service. Please back up any important data before returning for service or consultant arrives onsite. 5) A 15% restocking charge will apply on all returned goods claiming a refund. No refunds will be given after 14 days of purchase. All returned goods must be complete and in good condition and it is original package. 6) No refunds on consumables, unless stated otherwise or provided by original manufacturer. 7) All discrepancies with your purchase must be notified in writing within 24hrs of purchase.C 8) Customers are responsible for all courier and insurance costs for purchased and warranty goods. 9) Upon signing this invoice you acknowledge having read and agree to theterms and conditions of trading. 10)I acknowledge that the service has been completed to my satisfaction and that all the goods are in satisfactory condition.PROCEEDConsent(Required) I agree to the Terms And ConditionsPhoneThis field is for validation purposes and should be left unchanged.