Service information form
Who is returning the equipment?
Person to contact:
Date:
Phone:
Alternate contact:
Phone:
Return shipping Address:
Special shipping instructions:
What is being sent?:
Model number:
Serial number:
Please attach any relevant printouts when returning equipment.
Do not ship accessories that are not required to complete the repair (manuals, cleaning supplies, etc.).
What needs to be done?
1. Describe the conditions of the failure. (What was the failure? What were you doing when the failure
occurred? What software were you running? Is the failure repeatable?)
2. If the failure is intermittent, how much time elapses between failures?
3. Is the unit connected to any of the following? (Give manufacturer and model number.)
Personal computer:
Modem:
Network:
Other:
4. Additional comments:
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