Customer Work Order

Items in bold are required to complete your work order.

Customer/Billing Information

Customer Name:   Contact #1  Name:
Address: Phone:
Address cont'd: Email:
City:   Contact #2  Name:
Province: Phone:
Postal Code: Email:
 
Customer Ref. #:    

Printer Details

Printer Mfg: Printer Location: Use Customer/Billing Address
Model:
(e.g. HP 4250)
Address:
Serial: Address cont'd:
Part Number:
(e.g. Q5400A)
City:
Page Count: Province:
Warranty: Postal Code:
Purchase Date:    
Problem:
(1,000 characters)