Service Authorization Form

I'm requesting repair service for my* This field is required.

Personal Computer (Desktop or Laptop)

Business Computer (Office Computer, Database Server, Workstation, All in One, POS, etc.)

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(R) How will PowerUP POS receive your defective equipment?* This field is required.

I will drop it off at PowerUP POS's location

I will ship it to PowerUP POS

Any work required on my equipment will be performed remotely

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I will drop it off at PowerUP POS's location

I will ship it to PowerUP POS

PowerUP POS will pick-up the equipment from my business location

Any work required on my equipment will be performed remotely

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(R) Driving DirectionsPowerUP POS | 111 Weaver Rd, Warner Robins, GA 31093

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(R) Ship your equipment to:

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Business Address* This field is required.Enter your business address empty filed below (2nd) to calculate the distance between your business and PowerUP POS. Leave the 1st field as is.

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Full Name* This field is required.

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Business Name* This field is required.

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Business Phone Number* This field is required.

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Mobile* This field is required.

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Email* This field is required.

example@example.com

Email Verified

The verification code has been sent to some@email.com
Please check your mailbox and paste the code below to complete verification.

••••

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Equipment Information* This field is required.

I.e. Dell Inspiron 5537

I.e. S/N 10048 -OR- Ticket #: POW10617

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Is the equipment under warranty?* This field is required.

YESNO

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Warranty Information[OPTIONAL] Please upload any warranty documents, warranty cards or purchase order/invoice(s) that you have, which came with your equipment.

Drag and drop files here

Select files to upload

Browse Files

[OPTIONAL]

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Please provide your login credentials* This field is required.The username provided here should be an account with administrative rights. If it is a Limited or Guest user account, then this will be subject to additional charges as the Administrator Password would have to be reset.

USERNAME:

PASSWORD:

ACCOUNT TYPE:

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Data Backup* This field is required.By selecting any of the first two options, you agree that PowerUP POS will not be held responsible in case of data loss. You also agree & understand that Data Recovery will not be possible! By selecting the 3rd option of backing up your data, you agree that you will be charged $45 per 200 GB.

I already have a backup of my data. I DON'T NEED ANY OF THE FILES!

I DO NOT have a backup of my data but I DON'T NEED ANY OF MY FILES!

I need all of my files backed up or anything that can be savaged ($45 per 200GB)

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Problem Description* This field is required.Please describe the problem below (Check all that apply)

Applications Crash or Windows Blue Screens

Equipment Won't Boot or Power up

Equipment Freezes or Hangs

Equipment Shuts Down or Restarts

Equipment is Slow

Certain Applications Won't Open

Application(s) Freeze or Won't Operate

Getting Advertisements or Random Popups

Can't Logon

Display Doesn't Operate (Black or No Power)

Screen Artifacts / Fuzzy

No Power Indicator / Does Not Charge

Getting Error Messages

Cannot Access the Internet (Wired)

Cannot Access the Internet (Wireless)

No Sound or Noise Issue

Device Not Functioning

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Please provide a brief description of the problem along with any useful information* This field is required.

Small
Normal
Large
Huge

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Requested Services* This field is required.(CHECK ALL THAT APPLY)

Computer Build / Rebuild ($350) - (Hardware & Parts sold separately)

Computer Repair (Hardware) (2 hours min charge at $85/h, plus the cost of any required hardware parts)

Computer Hardware Add-on / Upgrade (2 hours min charge at $85/h, plus the cost of any required hardware parts)

Computer Repair (Software) (2 hours min charge at $85/h, plus the cost of the required software)

Computer Software Add-on / Update (2 hours min charge at $85/h, plus the cost of the required software/update)

Computer Tune-up ($85 Flat Rate)

Virus / Trojan / Adware Removal ($150 Flat Rate)

Data Recovery ($150 Per Incident)

Purchase & Installation of Windows Operating System / Upgrade ($399)

Windows Operating System Format & Reinstall ($250)

Purchase & Installation of Antivirus Software ($199)

Purchase & Installation of Microsoft Office Suite ($399)

Re-installation of Existing Software (Media & activation information are required) ($85/h, plus the cost of any required software/update)

Outlook Files Backup & Restore ($25)

Internet Browser Bookmarks Backup & Restore (Free)

Screen Pixel Restoration ($99)

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DATA RECOVERY DISCLAIMER* This field is required.

By checking this box you agree that you will be charged a NON REFUNDABLE fee of $150 for the data recovery process, regardless of the end result, and that PowerUP POS will not be held responsible in case of failure to recover your data to your satisfaction. You also agree that you have read, understood and accept to all terms listed above, and that you enter this agreement voluntarily, with full knowledge of its effect.

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Please select your operating system below* This field is required.

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Residential Authorization* This field is required.

I agree to pay the diagnostic rate of $75 regardless of the outcome

When diagnosis is complete, contact me at the email provided with the complete estimate of the work needed to be done, requesting electronic authorization. Do not proceed with my consent (Electronic Signature via DocuSign).

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Commercial Authorization* This field is required.

I agree to pay the diagnostic rate of $150 regardless of the outcome

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Diagnostic Software Installation[OPTIONAL] During the diagnostic process, various diagnostic software will be installed on your computer. Below, you'll find a part of the list of the software applications that will be installed and if selected, they can remain on your computer for your personal use, at no additional charge. Check the appropriate boxes to keep any of the applications for your personal use or leave them unchecked to have them removed from your system.

TEAMVIEWER: This is a remote support software which allows our technicians to remotely connect to your computer, ONLY upon your request and ONLY after permission is granted by you. This program it remains on your system by default, to provide easy access when needed. Uncheck the box to have it removed if you don't want to keep it.

REVO UNINSTALLER: This is a nice utility that can be used to uninstall unwanted software instead of the default windows built-in uninstaller. The difference is that REVO will actually scan & find all related leftover files found from the installation and give you the option to delete them all or a selection of them. It can also scan & delete all junk files, configure auto-start programs, clean cache & cookies from browsers, and much more.

WIN_DIR_STAT: Windows Directory Statistics, scans your data drives and tells you how much space is used up by various folders and files, all displayed in a neat tree-based hierarchy and a detailed graph view. WinDirStat is not only perfect for visualizing where your data is stored, it's also fantastic for cleaning up lost and stray files.

ADW_CLEANER: Designed to target malware that comes bundled with installer files, so it detects adware, toolbars, unwanted programs, browser hijackers, etc. Scan results are sorted as services, files, DLLs, scheduled tasks, registry entries and more, for easy identification.

CRYSTAL_DISK_INFO: This simple program gives you a complete overview of the state of your data drives, including HDDs, SSDs and USB Drives. Details include temperature, spin-up time, uptime, error rates, and more. It also calculates an overall health status.

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DISCLAIMER

By agreeing to keep any of the diagnostic software, you agree to release PowerUP POS of any responsibility from any damages caused to your system by the wrong usage of the software provided. All diagnostic software mentioned previously, it is not being sold to you but is only provided free of charge, only if you choose to do so.

All other requested software installation require original media (CD - DVD ROM), Serial Number(s), Activation Codes, Registration Credentials, including but not limited to MS Windows Operating System, MS Office Suite, and any other application that requires activation. PowerUP POS is not responsible to unlock/activate any software that activation information was not provided for.

PowerUP POS DOES NOT GUARANTEE to repair every computer that will be brought in. Often, computer equipment can be beyond repair especially if it’s really old, (5 years or older).

Apple Computers are not accepted.

Computers running Windows XP are not supported. Upgrade is the only available option.

Computers running Windows Vista (any edition), are not supported. Upgrade is the only available option.

Computers running Windows 7 (any edition), are supported, but upgrade to Windows 10 is highly recommended and by February 2020 will be required.

Computers running Windows 8 or 8.1 (any edition), are supported, but upgrade to Windows 10 is highly recommended.

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Pick a Date to schedule your appointment* This field is required.Monday to Friday Only. Holidays Excluded!

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Select a Time Window* This field is required.DURING NORMAL BUSINESS HOURS: 09:00 AM - 05:00 PM

Hour

Minutes

Hour

Minutes

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Your location Information:

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Calculation

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TERMS & CONDITIONS* This field is required.RELEASE FOR REPAIRS AND/OR SALES

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Digital Authorization & e-Signature* This field is required.Release for Repairs and/or Sales

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Total Repair CostThis is your total repair cost based on the services you requested. Enter your payment information below to proceed with your repair request.

Description

USD

+ OR enter a custom value

Credit Card Details

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

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