Sony Playstation 2 Repair Manual page 47

Referral Form from Powerful Guides
Name ___________________________________________________________________
Address ___________________________________________________________________________
City ________________________________ State _________ Zip _____________________________
Email ________________________________________________________________
Phone _________________________________ Daytime Number If we can not talk to you during business
hours your system goes to the back of the line.
Model # ______________________________________ Serial # ___________________________________
Total Enclosed $49.95 ($39.95 labor + $10.00 return shipping)
Payment Method – circle one
Check Money Order Credit Card
Credit Card Number __________________________________________ Exp. Date __________________
Description of problem with console
We/I authorize Video Game Repair (Herein referred to as "VGR") to diagnose/repair my gaming system and understand that VGR is
not responsible for any lost or stolen items in the mail or any other shipping method. We/I also authorize VGR to charge my credit
card the amount listed above. We/I also understand that all repaired systems are tested by qualified technicians before they are
shipped out to the customer. We/I also authorize VGR to make the necessary repairs to the unit and understand that if We decide the
system is not economically feasible to have repaired We/I will be held responsible to pay the required shipping fee of $10.00 per unit
and a diagnostic charge of $20.00 per unit to have the system returned to me. We/I also will not hold VGR responsible for any repair
damage done to my system if We/I have opened it up after We/I receive it back from the repair depot. We/I also understand that some
repairs take longer than expected due to parts availability and will not hold VGR responsible for any repair deadlines either expressed
or implied. We/I also understand that certain repairs might take additional time due to the nature of the repair and promise to be
patient in the repair process of my system.
Repair cost "does not" include main board replacement due to bad mods. The mainboard cost is $79.95 extra if
needed. *Also there is a $59.95 "Additional Charge" on laser eye's if one is needed for "Disk Read" error
corection.
Signature (Don't forget to sign) _________________________________________________
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