Service Form
Contact Info  
Company:
Address:
City:
State:
Zip code:
Contact name:  (full name)
Phone number:
E-mail:
Account info  
Account number:
PO:
Equipment type:
Brand:
Model:
Is your machine under service contract: Yes No
If you are requesting service for a machine under service contract, please include the usage (copier or printer) count.

State the situation:
 
For questions, please call service at 631-585-0684 ext 206 or 205