"Fast Affordable Data Recovery When You Need it Most"


Open 24 hours a day

7 days a week

 “Submission Form”


Please Take time to fill these forms out as thoroughly as possible. The more information we have the more chance there is we will recover your data.


Shipping Information:


Data Recovery USA Inc.

5801 Sw 188th Ave

Fort Lauderdale, Fl 33332


Toll Free: 1-877-230-3282

Fax: 1-954-337-0429


Client Contact Information

Company Name:

Contact Name:

Contact Position:

Return Shipping Address:


Cellular Phone:



Recovery technician with whom you spoke:

Work Order:

General Recovery Information

Software Version:

Operating System:

File System:


Storage Capacity:

Media/File Type:

Please list the most important data, files or types of files to be recovered:



How would you prefer your data returned to you:                             (size limitations do apply)

Via FTP______         CD_______             DVD_______              Client supplied______

Purchase a Hard Drive Thru Data Recovery USA_________    (contact QDR for pricing)

External USB/Firewire ______   /   Internal IDE _______


Please give a brief description of the events leading up to your data loss:



Payment Methods and Quote Information

Credit Card Type:

Credit card Number:

Exp. Date:

Name and Billing address on Card:





Price Quoted for Recovery/Repair:

NDA, Terms and Conditions

Client Authorization:

1.        The client hereby gives full authorization to Quickbooks Data Recovery (Q.D.R), its employees and agents to evaluate, receive and transfer any applicable Media, data or equipment to, from and between any of their laboratories and affiliates.

2.       The client gives permission to Q.D.R to perform an evaluation of the data loss in order to give a more accurate quote.

Limited Liability:

1.        Q.D.R makes no guarantee that data recovery will be successful.

2.       Q.D.R will not be held responsible for any damage due to shipping or transfer of equipment.

3.        Q.D.R will assume no responsibility for damage to data or equipment during the recovery process.

4.        Q.D.R will not be held responsible for any loss of revenue, time, data loss, or equipment damage. The client understands this is a risk of the data recovery process.

Legal Rights:

1.        The client shall maintain sole ownership over any data and/or equipment sent to Q.D.R.

2.        Q.D.R agrees to an absolute non-disclosure agreement on every recovery case.

Limited Data Warranty:

1.        Q.D.R will hold recovered data for a period of 10 days after providing the client with a copy of the recovered data.

2.        Should the data arrive damaged due to shipping Q.D.R will provide a new copy of the working data if alerted within the stated 10 Days.

3.        All data will be destroyed after 10 days for client security.

4.        Any equipment left unclaimed for 30 days will be disposed of after an attempt to contact the client is made.


1.        All shipping costs are the responsibility of the client regardless of the status of the recovery.


1.        Full payment is due upon completion of a successful recovery.

2.        Any evaluation fees will be paid prior to the evaluation being preformed.

3.        If we are successful recovering your data you must pay us in full.

4.        If the recovery is successful and the client cancels the recovery there will be a cancellation fee of %15 of the quoted job cost.

5.        Q.D.R accepts Visa, MasterCard, America Express, Pre-paid Money Order and Checks pending approval.

Data Guarantee:

1.        Your recovery comes with a data guarantee.

2.        If your recovery is not as promised Q.D.R will do everything in our power to rectify the recovery in question or we will provide a full or partial refund if notified within 10 Days.

Approved By (please print)_______________________     Date___-___-____


Signature: X______________________________