Request for Service

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Service Request

Fill out all Information
Company Name
Contact Name
Shipping Address
City, State, Zip		City State Zip
Phone Number and Ext		Ext
Fax Number
E-Mail Address

Please Answer the Following Questions
Did you purchase the Machine from BusinessNeedz.com?		Yes No
What is the brand of machine purchased ?
What is the Model Number?
What is the Date of Purchase?
What Error Code is it Displaying? (If no code is displaying type "NONE")
Describe the Problem that you are having
I understand by submitting this request for service, if the servicing company deems that the machine is malfunctioning due to impropper setup BusinessNeedz is not responsible for paying the service fee. BusinessNeedz is not responsible for setting up any office equipment. I understand that my credit card may be billed if the authorized dealer deems the equipment improperly setup ie. packing tape or material left on, toner strip not pulled, developer improperly poored in, scanner lock left in etc. I Understand (If this is left unchecked, service will not be provided)
I understand that if the machine needs parts, BusinessNeedz will provide the parts within the warranty period at no charge. We must first receive the defective part before shipping out the replacement or you can purchase the part and BusinessNeedz will credit the purchase upon receipt of the defective part. I Understand (If this is left unchecked, service will not be provided)