DR 2023

Date

Ticket #:

Claim #

Client Name

First

Last

Device Type

Wifi Only?

No

Yes

Has SIM Tray?

Yes

No

What type of device is it?

Make

Model

Model Number

Make (If Other)

Model (If Other)

Model Number (If Other)

Colour

Colour (If Other)

Capacity Capacity

Serial Number

IMEI Number (Phone)

Serial Number (If IMEI is unavailable)

IMEI Number (Tablet)

IMEI Response (Phone)

IMEI Response (Tablet)

Laptop Make

Laptop Model

TV Make

TV Model Number

Signs of liquid damage?

No

Yes

Unable to verify

Photo/s of liquid damage

Maximum file size: 134.22MB

Date of last use known?

No

Yes

Date device was last used:

Last date of use not known.

Cause of damage:

These parts have been damaged:

Other parts that have been damaged:

Device Condition

Please insert any additional notes in the 'Technician Notes' field.

Assessment Type:

In House Assessment

On Site Assessment

Virtual Assessment

Methods of Testing:

Hardware

Software

Unable to test - No passcode provided

Unable to test - Device dead on arrival

Technician notes:

Technician

Technician recommendation:

Repair

Replace

Technician signature: [168]

Clear

File Upload

Maximum file size: 134.22MB

Parts Needed:

Cost:

excl. VAT

Add Remove

Item not on list: (courier, etc)

Item

Cost (incl. VAT)

excl. VAT

Add Remove

Our technician is of the opinion that this device is not repairable due to the following:

Platinum Repairs: Trustworthy Tech Repairs In South Africa

Device Condition

Parts Needed:

Item not on list: (courier, etc)