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:	Ontario Quebec Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Prince Edward Island Saskatchewan Yukon Territory	Phone:
Postal Code:		Email:
Customer Ref. #:

Printer Details

Printer Mfg:	- Select Printer Mfg. - Brother Hewlett Packard Kyocera Lexmark Okidata Other Panasonic Ricoh Samsung Sharp Toshiba Xerox	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:	Ontario Quebec Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Prince Edward Island Saskatchewan Yukon Territory
Warranty:	None Manufacturer Printers Plus Unknown	Postal Code:
Purchase Date:
Problem: (1,000 characters)