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American Barcode and RFID Service
Depot / On-Site Equipment
Repair Request Form

Depot / On-Site Request Form
 
First Name:
Last Name:
Daytime Phone:
Fax:
Company:
E-mail:
 
 
Street Address:
Street Address 2:
City:
State:
Zip Code:
Country:
 
Will the Repair be Depot or On-Site? Depot:      On-Site:
 
Please indicate the equipment you wish to have repaired
Manufacturer :
Part # :
Quantity :
 
If broken equipment, what was the situation that led to the equipment breaking down?
 
Do you currently have a service agreement with American Barcode on any of your data collection or printing products? YES:      NO:
 
In what type of environment is this equipment used? (in a warehouse, outside, etc.):
 
If label or card printer, what type of media (labels/ribbon) and printhead is used?
 
What is the best way our Service Representative can reach you?
 
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