CLIP REQUEST FORM

Use the form below to request a clip from UAS. Complete all available fields.

Form ID: 1428770021

Requester Information

Company:
Title:
Name:

Store Information

Please entering the store number and zip code to search for the location. If you do not know or if there is no store number, please click Enter Manually and enter the required information.

Store Number:
Store Zip Code:
 

Clip Guidelines

Clip Information

Due to the nature of remotely retrieving recorded video, please limit clip requests to one camera and up to one hour. Requests in excess of these guidelines, or requests placed after 2:00pm EST may take an additional day or more to process and may incur additional charges.

Please describe the event you are looking for:
Please list the cameras you are requesting:
Number of Requested Cameras:
Clip Start:
Clip End:

Burn Cost

Hours:
Burn Cost:

Delivery Options

Delivery Options:
Electronic Delivery

Physical Delivery:




Ship-To Address

PLEASE NOTE: For security purposes and to maintain the integrity of your video, RAVEN Clip Discs will no longer be shipped via U.S. Mail. All RAVEN Clip Discs will be shipped via trackable delivery.

Name:
Address 1:
Address 2:
City:
State:
Zip:
 

Media

The first copy of a CD is included in the price. Each additional copy costs $5.00.

Number of copies:

Video Quality:
Media Type:

Cost

Burn Cost:
Media Cost:
Delivery Cost:
Total Cost:

Signature Details

As your online signature, you MUST reenter the following information.

Name:
 
Title:
 
Email:
   

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