Minorjewelry.com   Rolex Repair Information Form	Minor  Repair
1. Please fill out form.	2611 12th  Avenue South
2. Print and include with watch.	Nashville - Tennessee - 37204
3. Submit for processing of your repair.	877-477-7077

Name
Company
Shipping Address
City , State  Zip
Telephone
FAX
E-mail

Reason for Repair
Service Watch	Refinish Case and Band Only	Refinish Dial
Leaks Water	Convert to Sapphire Crystal	Add Diamonds to Dial
Will not run at all	Replace Crystal	Replace Hands
Dropped Watch	Replace Crown	Replace Insert
Band Repair	Replace Case Tube	Replace Bezel

Watch Information	Fill out as much as you can
Model Number		Case and Band	Steel Steel and Gold Gold 18k Gold 14k
Serial Number		Type of Dial	Stick Marker Other 8 Round 2 Baguette Diamond Dial
Name on Dial	Datejust Date Day Date GMT Submariner Daytona Yachtmaster Sea Dweller Oysterquartz Explorer Air-King Oyster Perpetual Masterpiece Cellini	Color of Dial	Black White Blue Oyster-Silver Champagne Other
Shipping Insured Value $		Type of Bezel	Fluted Diamond Other Smooth Engine Turned
Comments
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