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Please tell us a little bit about yourself.
Your Name
Business Name
Phone #
Email Address
Street Address
City, ST & Zip Code
Please tell us how we can help.
What type of service are you interested in?
On-Site Maintenance & Repair
Carry In Maintenance & Repair
On-Site Maintenance Agreement
How many machines would you like to get serviced?
1
2
3
4
5
6 - 10
11 - 20
21 +
Primary Business Machine Make
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Brother
Canon
Copystar
Epson
Fujitsu
Gestetner
Hewlett Packard
Konica Minolta
Kyocera
Lexmark
Muratec
OKI
Panasonic
Ricoh
Samsung
Sharp
Toshiba
Xerox
Other - Please Specify Below
Primary Business Machine Model
Please let us know if you are experiencing any of these problems.
No problem - Routine Maintenance only
Poor Copy / Print Quality
Paper Jamming inside the Machine
Machine is inoperable - Error Code
Machine is inoperable - Part is broken
Machine is inoperable - No Power
Connectivity Problem - Cannot Print
Connectivity Problem - Cannot Scan
Connectivity Problem - Cannot Fax
Other - Please specify
Please let us know if you have additional machines or give us any addition information that you think will help.
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