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Customer Order Form
Full Name
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Email Address
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Phone Number
Shipping Address
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City
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Zip Code
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Country
Billing address(If different from shipping address)
Special Instruction
Terms & Condition
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Confirm Order
Horafox form
Watch Serial Number
Brand
Model
Year of Manufacture
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2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1900
Date of Service
Service Center
Description of Service
Current Condition
Choose an option
New
Used
Damaged
Heavily Damaged
Visual Inspection Note
Modification
Horologist Signature
Add picture of watch (Front of Watch), and one (Back of Watch)
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Choose Files
Parts Replaced: (if multiple parts replaced then have a plus button and can add)
Vendor Orders
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