Service Request Form

Service Request Form

Please fill out this form to the best of your ability.
Are you a new customer?*

YesNo
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date*

MonthDayYear
Date
Company Information
Is this for a personal or company request?*

PersonalCompany
Company
Company Name
Requested By
Full Name
Work Order # (If Applicable)
WO # / PO #
About Your Device
Device*

Desktop PCLaptop PC (Please provide charger)iMacMacBookMobile DevicePlayStation 4/5Xbox One/Series X/SOther
Light Year Computers, LLC, unfortunately, cannot repair any Apple products. This is due to Apple's stance against Right-To-Repair. We apologize for the inconvenience. However, we can conduct services on Apple devices such as Tune-Ups, Virus Removal, Data Backup & Data Transfer/Clone. Thank you.
Brand
Model
Serial Number
Operating System*

Windows 10Windows 8.1Windows 7Older WindowsMacOSiOSAndroidPS4 OSPS5 OSXbox OSUnsure
Date Purchased (If Known)

MonthDayYear
Date
Services (Select all that apply)*

DiagnosticsCustom PC BuildData BackupData RecoveryData Transfer/CloneHardware UpgradeMAYDAY Remote AssistPC RepairTune-UpVirus RemovalUnsure
What's wrong with your device? Please be as detailed as possible- including crashes and glitches, error messages, new software and/or hardware recently installed, and anything you have done to try and fix the problem.
Please provide details about your desired Custom PC Build- including ideal use, specific hardware, visual design, programs, games, etc.
What is your max budget, in dollars, for this Custom PC Build? (If unsure, type "0".)
Budget Amount
Please provide any pictures you may have to help illustrate your design ideas.

Browse Files
Pictures, Documents, Etc. Cancelof
How much data, in GB, are currently on the hard drive that you want backed up? (If unsure, type "0".)
Gigabytes
Where would you like your data backup to be stored?

Light Year Computer's Secured ServerExternal Drive provided by Light Year ComputersPersonal External Drive
What is the type of the hard drive that requires recovery?

Mechanical Drive (HDD)Solid State Drive (SSD)Unsure
How old is the hard drive requiring recovery?

0-1 Year Old1-3 Years Old3-6 Years Old6-9 Years Old9-10+ Years OldUnsure
What is the state of the hard drive that requires recovery? (Select all that apply.)

Perfect ConditionNormal WearPhysically DamagedCorruptedUnsure
Describe in greater detail any known issues with the drive both digitally and physically, if at all.
How much data, in GB, are currently on the hard drive that requires recovery? (If unsure, type "0".)
Gigabytes
How much data, in GB, are currently on the hard drive that requires transfer/cloning? (If unsure, type "0".)
Gigabytes
What type of hardware would you like to upgrade/add to your system? (Select all that apply.)

Processor (CPU)Cooling SystemMotherboardMemory (RAM)StorageGraphics Card (GPU)CasePower Supply (PSU)Peripherals (Mouse, Keyboard, Headset, Etc.)Case Accessories (Fans, Visuals, Etc.)Expansion Units (Sound Cards, Network Cards, CD/DVD Drives, Etc.)
Please list the current hardware in your system- preferably with brand, series, and model information. (If unsure, type "Unsure".)
Date Last Serviced (If known)

MonthDayYear
Date
Payment Information
Do you have a Card-On-File with us?*

YesNo
Would you like to add a card for future invoice use? All information will be stored in our highly secure and private records, only for use of payment collection of complete services. You may remove this anytime.

YesNo
Please Review, Sign, & Submit When Ready
Signature*

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Service Request Form

Company Information

About Your Device

Payment Information

Please Review, Sign, & Submit When Ready