Hard drive disk or other media repair form for diagnosis for MATRIX UAB authorised dealers


- Data recovery pricelist ;

Repair acception Form No.
____________ (this reception form in English DOC type version is here ...>>> )

No. Question Answer
1 Media owners name:  
  Clients phone, email, skype:  
  Clients representative person (name, surname, position):  
  Reception date, time:  
  Way of sending to Matrix UAB laboratory parcel post department, couriers, self-delivery, other (correct please underline)
  Time to be received to our laboratory or time to take from parcel post in bus station (date, time):  
2 Media maker/manufacturer: Possible vendors:
Seagate, WD (Western Digital), Hitachi, Samsung, Maxtor, Excelstor, Fujitsu, IBM, HP, Compaq, Toshiba, Lenovo, other: ________
  Media model:  
  Media part/no (P/N):  
  Media type: hdd, usb drive, flash card, magneto optical disk, floppy disk, cdr/dvdr, tape, sim card, other (correct answer please underline)
  Media DCM (drive configuration model) code (for WD):  
  Media MLC code (for IBM/Hitachi):  
  Media firmware (Seagate, Samsung, Toshiba, etc.):  
  Media electronic board (PCB, PCBA) model:  
  Media main chips models/codes:  
  Media hermetical block (HDA=hard drive assembly) model:  
  Media spindle engine model:  
  Bar codes on MAXTOR hdd (there are two bar codes, one with model, other with letters, for ex. N,M,D,B)  
  MAXTOR hard disk drives - Unique code:  
  MAXTOR hard disk drives - code:  
  Configuration code (Config) (for Seagate usually)  
  Media capacity, GB:  
  Partitions, their quantity, each partition's file system, partition's approx. size

partitions size _____, file system (FAT/FAT32/NTFS/Ext2/Ext3/RiserFS/______ )
partitions size _____, file system (FAT/FAT32/NTFS/Ext2/Ext3/RiserFS/______ )
partitions size _____, file system (FAT/FAT32/NTFS/Ext2/Ext3/RiserFS/______ )


3 Media serial no.  
  Media electronics board (PCB, PCBA) serial no.  
  Media hermetical block (HDA) serial no.  
4 Media visual view, physical-mechanical damage, dents, breaches, broken chips  
  Did media suffered effect of:

smash-hit/water/fire/lighting/electrical discharge (correct please underline), for what time?


5 I agree my media to be opened and it will become with no warranty yes/no (correct please underline)
  Do you supply additional media donor, and what model: yes/no (correct please underline)
  Did your company have bought at the same time more same model hard disks, media or same model computers, from which media is?  
  Warranty is active for media, labels are not broken? yes/no (correct please underline)
6 If this data recovery case is being done for criminal investigation, or by court decision, or by field research, do you need forensic evidence? yes/no (correct please underline)
7 Malfunction according to a client (description in own words):  
  Media strange or unusual sounds, and of what type:  
  Does hard disk engine is spining?  
  Is hard disk (media) seen by BIOS? Does model shown correctly? If not what letters are visible?  
  Is hard disk (media) seen by OS (operating system, windows/linux/unix/MacOS/other):  
  Media behaviour before failure:  
  Supposed failure by a representative person:  
  Critical files needed, their extensions, approx. size ot them:  
  Any passwords on media, OS or other important folders/critical files, if yes indicate users and passwords  
  Till date date it needed mostly, is it urgent, if data are used constantly (databases, accounting)  
  Do you agree to pay for urgent processing (in 1-2 hours)? yes/no (correct please underline)
  Data type: personal, companys-commercial, accounting, server, backups (correct please underline)
  What steps were done by client itself for data recovery, how a client was trying to recover his data, if yes, contacts of a person who have tried to do this  
8 Where to write recovered data: ftp/hdd/cdr/dvdr/usb flash/card (correct please underline). Remark: if data are written to a hdd, no additional fee, if to a dvdr, it is 5eur+VAT for each dvdr
  Does client give a media for writing, and what model?

hdd/cdr/dvdr/usb flash/card (correct please underline),
media model, serial no:
client wants to buy from us media, if yes what type and size:


  How a client takes back his recovered data: self service from our office/from our representative/ftp/send by carrier/send by bus /send by parcel post (correct please underline)
  Do you agree to leave your failed media for parts to us, if diagnosis is free of charge, or we apply additional discount deducting media price? yes/no (correct please underline)
9 Service type, needed: a) data recovery, password removal from media/files, logical recovery;
b) Media repair without saving data;
c) data destruction, physical media and data destruction
(correct please underline)
10 Name of our dealer company, which received media for diagnosis  
  Person who consulted and accepted (name, surname, position):  
  Dealer persons phone, mail, skype:  
11 I agree that all this information above is correct and agree with these conditions, signature:  
  I have accepted according clients data, signature:  

If your hard disk is broken or not working, you need data recovery in Lithuania or Baltic states, please write to service@matrix.lt or call +370-698-39001, +370-674-88995.

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