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First Name:* |
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Last Name:* |
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Daytime Phone:* |
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Email You MUST provide * |
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Type of Watch: |
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Case/Band Color: |
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Manufacture (brand): |
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Model # (on case back): |
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Serial # (on case back): |
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Declared Value of Watch:* |
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Do you bathe or swim w/ watch?: |
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Water Resistance Level
(on case back): |
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Have you or a jeweler opened the watch for repair? |
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When was the watch last serviced? |
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Who serviced the watch? |
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Where was the watch purchased? |
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How old is the watch? |
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Is the watch working/keeping time? |
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Is the watch intact, or in several parts? |
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Describe the problem: |
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Type of Repair/Service
you are inquiring about? |
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Inquiring about more than one SERVICE, please specify in this area using the information in the drop-down box above. |
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Type of Part(s) you are inquiring about? |
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Inquiring about more than one PART, please specify in this area using the information in the drop-down box above.
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