Service Request Form for Photo Restoration
Photo #1 Resize to: Special Instructions
Cost
Same
as original _____
4 x 6 ______ $35.00
5 x 7 ______
8 x 10 _____
9 x 12 or larger ____ ($55.00)
Number of additional copies (if desired) ____ x $5.00 each =
Additional copies of 9 x 12 or larger ____ x
$9.00 each = _______
Photo #2 Resize to:
Special Instructions
Cost
Same
as original _____
4 x 6 ______ $35.00
5 x 7 ______
8 x 10 _____
9 x 12 or larger ____ ($55.00)
Number of additional copies (if desired) ____ x $5.00 each =
Additional copies of 9 x 12 or larger ____ x $9.00 each
= _______
Use back side for additional photos.
Photo Total ________
________
If you
want your photos returned by Registered Mail, add $11.00)
_________
(For NY residents only) NYS Sales Tax _________
Grand Total __________
Name: _______________________________________________
Shipping Address: ______________________________________
_______________________________________
Phone: ________________ Email Address: _____________________________________
Send your check (made payable to Croton Stamp Co.) or
credit card information together
with your photos to:
PO Box
242, Goshen, NY 10924. Use care in packaging your photos. Reinforce the package
properly.
Your originals will be returned to you along with the enhanced photographs. Your
satisfaction
is guaranteed or your money back. We reserve the right to return photos that we
deem are
beyond our ability to significantly repair or enhance. Use the back of this page for
additional
instructions.
Credit card information:
1. Name on card:
2. Credit card type (M/C, Visa, or Discover Card):
3. Credit Card #:
4. Expiration date:
5. Security code #: this is a 3 digit number found on the reverse side of
the card at the far right side of the signature box _______
6. If your credit card billing address is different from your shipping address
above, please list it below: ____________________________________
____________________________________
____________________________________
Croton Stamp Co., PO Box 242, Goshen, NY 10924
Phone (845) 294-7361 Fax (509) 471-8979
Email: croton@warwick.net
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