Accutron Mail In Repair Form Old Father Time
Mail In Repair Form
116C Ballast Rock Rd
Powells Point, NC 27966
(252) 371-1656
"First, BOOKMARK This Page for
Easy Access Next Time You Visit"

1.  Mailing Address

First Name *MI   *Last Name
* Address
Suite or Unit #
*City   *State   *ZIP + 4 -
* Indicates Required Field
This should be the address used for your Credit Card Statement
*Sorry, we no longer accept International Repairs (including Puerto Rico and the Virgin Islands)

Contact Information

Daytime or Mobile Phone
  Alt Phone
EMail Address  (your estimate is sent by email)
Please ADD to your email contacts to receive your repair estimate.
**Note:  If E-mail address is not available, we'll send your estimate by postal mail.

3.  Shipping Information (If Different from Mailing above)

*First Name *MI   *Last Name
Company Name
* Address
(We cannot deliver to PO Boxes)
Suite or Unit #
*City   *State   *ZIP + 4 -

4.  Repair Item Information

Describe the Item You're Sending In
Serial Number (If Available)

Comments/Service Requests
(Limit 1,000 Characters)

Repair Warranty Information Link

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.  We can provide a written appraisal of your item, (including digital photographs).  This Professional Appraisal can be used to add this property to your homeowners insurance.  Our 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 another time.

6.   Payment Method
This authorizes Old Father Time to charge your card $65 for Estimate and Shipping fee if you decide NOT to repair the watch.  An additional bank card fee is applied for credit/debit cards.  If using Personal Check, your check should be included with the watch and this form.  I'm sorry we cannot accept Postal Money Orders.

Personal Check
Include your check w/Shipment

MasterCard or VISA
Credit Card Number         
Exp. Date (any format)     Card ID Number (where can I find this)

Name as it Appears on Your Card

Signature _______________________________________________________  Date __________________________

7.  How Did You Find Us?

8.  Your US Postal Service Shipping Label
(Clip-Out & secure this label to your package) USPS Registered, Insured Recommended


116C Ballast Rock Rd
Powells Point, NC 27966

9.  Print Your Repair Form & Shipping Label

1)  Complete the form on your screen, then print
2)  Sign the credit card information section, or attach your check (your choice).  
3)  Cut out the shipping label above and affix it to your package securely if using the US Postal Service.
4)  Package watch securely and 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, but we only offer repair services to US customers, and no longer handle International repairs, unless with a US Agent,
(including Puerto Rico and the Virgin Islands), or repairs for the Jewelry Trade.
7)  Packaging and shipping suggestions can be found HERE
)  Click these links for:  Repair WARRANTY  or Company Policies