First Name*MILast Name* *Billing
Address Add'l
Address Space City*State*(2 digits)Zip Code
* Indicates Required Field *Sorry, No International Repairs
2.
Contact Information
E-Mail Address
(we'll
notify you of estimates by e-mail)
**Note:
If E-mail address is not available, we'll send your estimate by regular mail. ADD
us to your email friends (or preferences) to
receive your email estimate from
watchmaker@oldfathertime.com
Daytime Phone Number* Evening Phone Number*
3.
Shipping Information (If Different from Billing) Sorry, We
Cannot Deliver to PO
Boxes, please enter physical address ONLY
First NameMILast Name
Company Name
Shipping Address
(no PO Boxes, please) Add'l Address
Space
City
State(2
digits)Zip
Please
use care in completing shipping address. Address correction
charges of $12.50 will be applied by the carrier
for
incorrect delivery information. A Signature will be REQUIRED for Delivery
4.
Repair Item Information
Describe the Item You're sending in for Repair
Serial Number
(optional)
Comments/Services Requested:
(limit 1,000 characters)
It helps the
watchmaker to have as much information as possible about what the
timepiece is doing or not doing.
If this form is being used for
crystal replacement, jewelry work, etc., please state. Also,
please indicate
WARRANTY ISSUES here. If damage is due to
accident, check with your insurance company. Repairs are often
covered by
homeowners insurance.
5. Professional Appraisal Service
(Please check one)
YES
-
Check this box if
you'd also like us to include a professional appraisal of your item after
restoration. As Certified Personal Property Appraisers, and GIA
Certified Gemologists, we can provide a written
appraisal of your item,
(including digital photographs). This Professional Appraisal can be
used with your
insurance company, in the event of household theft or fire.
It can also be used to add to your existing homeowners insurance with a
special rider for jewelry or antiques. Without specific coverage,
most insurance polices have
very low benefit limitations on jewelry and
antiques. Our Professional Insurance Appraisals are provided at a
discounted price of $85, (regular price $125), when performed in
conjunction with repairs, and will be delivered with your repaired item.
NO,
Thanks. Maybe some other time.
6. In order to better
serve you, please tell us how you learned of Old Father Time's repair and
restoration services :
7. Payment Method (please choose one)
Credit Card Number
Exp. Date
(any format)
Card
ID Number
(What's this??)
Signature
*
*$65
Estimate fee for Vintage Watches produced prior to 1995
*Free
Estimates for Contemporary or Swiss Watches produced after 1995
8. Your Shipping Label
(for
your convenience when using US Postal Service, Complete, Clip-Out,
& secure this label to
your package)
USPS
Registered, Insured is Recommended
From:
OFT 16595 Pouncey Tract Road
Suite 2
Rockville, VA 23146
9.
Print Your Repair Form & Shipping Label
1)
Using the button (ABOVE), Print this
Form and send it along with your repair item.
2) Sign the credit card information section, (if
applicable), and double-check for accuracy.
3) Cut out the shipping label above and affix it to your package
securely if using the US Postal Service. 4) Include your repair form in the box
when shipping.
5) Please remember not to send your original or manufacturer box or
material as it will be discarded.
6) Sorry, we no longer offer International or Trade Repairs.