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SERVICE REQUEST

Press the SUBMIT button to submit your information after you are done filling out the form.

* denotes required field

Equipment Information:

* Equipment ID Number (EID):   5 Digit alphanumeric EID is located on a blue label on the front of the machine.
                   * Machine Status: Select Status Equipment is not working Equipment is working
                  * Contract Status: Select Status Equipment is under contract Equipment does't have contract
            * Problem Description: Select Description Accessory Cannot Print Cannot transmit/receive faxes Error Code Install/Deinstall/Retrofit Jamming Poor Copy/Print Quality Preventative Maintenance Other
                            Comments:
                                              Please be brief, field accepts 50 characters.

Contact Information:

Company Name:
     * First Name:                                     Last Name:
           * E-mail:                                * Verify Email: