Contact InformationCompany*Name*Email* Phone*Purchase Order No.Machine InformationSystem Number*Serial NumberModel NumberMachine TypeB/W CopierColor CopierRISO DuplicatorFax MachinePrinterShredderMachine BrandBrotherCanonFellowesHewlet PackardLexmarkRISOOKIDescription of Problem (be specific)*NameThis field is for validation purposes and should be left unchanged.