PCW Form

1
Thank you for your interest in our repair services!

Please fill out out repair form in its entirity or to the best of your ability.

If you encounter any issues please
email us at help@precisioncameraworks.com or give us a ring at 847-470-3350

We do not respond to these forms individually.

In order to receive an official PCW estimate you must send in your equipment for evalaution.

If you would like to discuss anything regarding service prior to shipping please reach out to us via phone or email.
2
DateThe date you submit this form does not have to be the day you ship your equipment.
Date
Month
Day
Year
3
Name* This field is required.
First / Preferred Name
Last Name
4
Email Address* This field is required.
5
Phone Number* This field is required.
Area Code
Phone Number
6
Billing Address* This field is required.
Address Line 1
Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
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Montenegro
Montserrat
Morocco
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Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
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Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
7
Shipping Address If this address is same as the billing, leave blank.
Address Line 1
Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
8
Equipment Type* This field is required.NOTE FOR ARCA-SWISS USERS: ARCA products do not have serial numbers.
ARCA-SWISS
Compur (Synchro, Press, 00, 1, 2, 3, Linhof)
Copal (Press, 0, 1, 3)
Hasselblad
Mamiya
Noblex
Sinar
Widelux
Other
9
Model: Serial #: Complaint :
10
Model: Serial #: Complaint :
11
Model: Serial #: Complaint :
12
Model: Serial #: Complaint :
13
Model: Serial #: Complaint :
14
Model: Serial #: Complaint :
15
Please make sure there is no film in your camera.
If you are unable to remove the roll prior to shipping, please indicate it on a post it note attached to the back of the camera.
16
Accessories Included
Quantity
Front Lens Cap
Row 0, Column 0
Rear Lens Cap
Row 1, Column 0
Body Cap
Row 2, Column 0
Lens Filter
Row 3, Column 0
Viewfinder
Row 4, Column 0
Case
Row 5, Column 0
Dark Slide
Row 6, Column 0
Lens Shade
Row 7, Column 0
Camera Strap
Row 8, Column 0
Original Box
Row 9, Column 0
Negatives
Row 10, Column 0
Batteries
Row 11, Column 0
Diopter
Row 12, Column 0
Other (list below)
Row 13, Column 0
Front Lens Cap
Rear Lens Cap
Body Cap
Lens Filter
Viewfinder
Case
Dark Slide
Lens Shade
Camera Strap
Original Box
Negatives
Batteries
Diopter
Other (list below)
Quantity
Row 0, Column 0
Quantity
Row 1, Column 0
Quantity
Row 2, Column 0
Quantity
Row 3, Column 0
Quantity
Row 4, Column 0
Quantity
Row 5, Column 0
Quantity
Row 6, Column 0
Quantity
Row 7, Column 0
Quantity
Row 8, Column 0
Quantity
Row 9, Column 0
Quantity
Row 10, Column 0
Quantity
Row 11, Column 0
Quantity
Row 12, Column 0
Quantity
Row 13, Column 0
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Additional Comments
18
Thank you for completing our repair form!
We look forward to working with you.

If you have questions prior to shipping your gear, please feel free to reach out via email help@precisioncameraworks.com or give us a call at 847-470-3350.

Please prepare to ship your equipment to the following adress as it is listed below:

2121 LOHMAN'S CROSSING RD

STE 504-769

LAKEWAY, TX 78734
Should be Empty: