Accutron Mail In Repair Form Old Father Time
Mail In Repair Form
PO Box 1265
101 Airstrip Road

Kill Devil Hills, NC 27948
(252) 371-1656


1.  Mailing Address

First Name *MI   *Last Name
* Address
Suite or Unit #
*City   *State   *ZIP + 4 -

2.  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.

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 __________________________

1)  Complete the form on your screen, then print
2)  Sign the credit card information section, or attach your check (your choice).  
4)  Package watch securely and Include your repair form in the box when shipping.
5)  Do not 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,
        (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