Please ship your watch to:

RJI or Suzie Kochayan
1200 4th Street
San Rafael, CA 94901

Phone: 1 (415) 453-3580

Watch Repair Form

This form is for you to print out and mail with your watch. It is not a form to fill out online because we cannot diagnose your problem or give you an estimate without inspecting your watch.

PLEASE PRINT CLEARLY

Name: ____________________________________________________________

Street Address: _____________________________________________________

Apt. or Unit: ______________

City: ____________________ State: _________  Zip Code: __________

Daytime Phone: (        ) ______-______________   extension _________

Evening Phone: (        ) ______-______________

Email address: __________________________________________

Brand of Watch: _________________________________________

Model or Serial Number (if applicable): _______________________

Declared Value (this is the amount we should insure your watch on its return)

$_________________

Please describe the problem you are having with your watch, or provide instructions (e.g., change battery, check water resistance). Please be specific.

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

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Please call or email if you have any questions about sending your watch to us.

Please ship your watch to:

RJI or Suzie Kochayan
1200 4th Street
San Rafael, CA 94901

Phone: 1(415)453-3580