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Shipping/Repair/Restore Request Form
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Important Note:
Please complete this entire form , providing us with all details necessary to finish the repairs and/or restoration of your watch properly. The www.my-watch-repair.com is not responsible for damaged or lost items while in transit. Preferred shipping: Value of $100 and below ship USPS Priority & Insured with delivery confirmation. Value of $100 and above ship USPS Registered & Insured. Thank you!


First/Last Name: _____________________________________________________ Date: ____________

Address: _______________________________________________________________________________

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City: _____________________________ State: ___________________________ Zip: _____________

Telephone: _______________________________________________________________________________

Fax: ___________________________________________________________________________________

E-Mail: _________________________________________________________________________________

Description of Item Sent: _________________________________________________________________

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Select One: □ REPAIR □ RESTORE

Serial Number: __________________________________________________________________________

Describe Repairs/Restoration: _____________________________________________________________

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www.my-watch-repair.com Staff Use Only

Customer ID Number:___________________________________
Date Returned: ________________________________________