Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Primary Phone Number *

(###)

###

####

Alternate Phone Number

(###)

###

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Return Shipping Address Same As Above? *

Yes

No

Complete if Return Shipping Address Is Different Than Above

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Add Signature Guarantee To Return Shipment *

Yes

No

Method To Receive Your Digital Images *

USB Flash Drive

DVD Set

Download Link To Your Digital Images

Individual Photos Scanned

300 d.p.i. - 12 Cents Per Photo

600 d.p.i. - 15 Cents Per Photo

Reverse Side Scanning Of Photos Captures Text & Dates - 3 Cents Per Photo

Yes

No

Individual 2" x 2" Slides Or 35 mm Negative Frames

2400 d.p.i. - 27 Cents Per Slide Or 35 mm Negative Frame

3200 d.p.i. - 33 Cents Per Slide Or 35mm Negative Frame

4800 d.p.i. - 39 Cents Per Slide Or 35mm Negative Frame

Individual Non 2" x 2" Slide or 110, 126, 127, Disc, Medium, or Large Negatives

2400 d.p.i. - 85 Cents Per Slide / Negative Frame

3200 d.p.i. - 99 Cents Per Slide / Negative Frame

4800 d.p.i. - $1.25 Per Slide / Negative Frame

Photo Album / Scrapbook / Artwork Scanning

300 d.p.i. - 75 Cents Per Page

600 d.p.i. - $1.10 Per Page

Image Archive - $10.00 - Allows For Future Reorder 1 Year From Return Ship Date

Yes

No

Slide Show - $50.00 - Up To 500 Images With Title Slides & Transitions - Does Not Include Scanning

Yes

No

Rush Service $50.00 - 48 Hour Processing Upon Receipt - Based On Availability

Yes

No

Copyright Agreement *

Scan To Digital will not, unless you are the owner or have permission to reproduce the work, duplicate or accept any copyrighted materials. You agree, by sending us your order that you are the owner or have permission to reproduce the work. It is the responsibility of the customer to obtain a release waiver signed by the photographer if the images you submit have a copyright symbol (©). This release waiver must state that you are allowed to have the image duplicated, restored, altered, copied or scanned. You must include a copy of this release waiver with your shipment to Scan To Digital. If we do not receive a release waiver, you are implying that these are your photos and you grant or have permission to have it duplicated or scanned. You agree by submitting your order to indemnify and hold Scan To Digital and its employees, agents, officers, directors, affiliates, licensors and business partners harmless from and against any and all costs, damages, liabilities and expenses (including attorneys’ fees and costs of defense) scan to digital or any other indemnified party suffers in relation to or arising from a breach of your representations and warranties.

I Agree

Limit Of Liability *

We aim to provide our customers with the very best work and we always strive to make sure to protect your orders. Submitting any print, film, document, digital media, or miscellaneous object to scan to digital for processing, printing, scanning, photo restoring or other handling constitutes an AGREEMENT by you that no warrantee is established or entered into and any loss or damage by Scan To Digital, our company, subsidiary, or agents, will not entitle you to any compensation nor recovery. Acceptance by our company, subsidiary and/or agents of the print, film, document, digital media, original photos for restoration, or miscellaneous object is without other liability or warranty, and recovery by anyone for any incidental or consequential damages is excluded irrespective of whether the damage occurs because of our negligence, breach of contract, strict liability or other cause. We are not responsible for orders or materials left unclaimed for more than 30 days after completion of our process. We may change our prices and services without notice. Whether damaged by fire, lost, through negligence, theft, or any other means, for customer supplied items that are submitted with orders, Scan To Digital does not assume any liability. YOU AGREE THAT SCAN TO DIGITAL IS NOT LIABLE AND THERE WILL BE NO COMPENSATION OR PAYMENT OF ANY KIND IN THE UNLIKELY EVENT THAT YOUR ORDER IS MISPLACED, LOST OR DAMAGED.

I Agree

Digital Signature *

First Name

Last Name

Date *

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YYYY