Equipment ID
OR
Model and Serial Number
P.O. Number: (If needed)
My machine is working My machine is not working: Down Machine My machine is jammed My copies have lines My machine indicates Preventive Maintenance Time My machine indicates Needs Toner
Description of Problem Toner Spill Network / Printing Color Quality Copy Quality No Power Multiple Feeding Original Jam Double Sided Copying Jam Paper Jam in Sorter/Finisher Noise Miscellaneous Paper Jam Preventive Maintenance Service Code Skewing Stapler Problem Toner Waste Fax Problem Blank Copies Courtesy Call Other
Customer Comments (Problem Description)
Your name (or Contact at location)
Please enter a phone number you can be contacted at, if further information is required
Contact Number: ( ) -
Please enter a fax confirmation number if you desire a fax confirmation
Fax Confirmation Number: ( ) -
