HP 4100n HP LaserJet 4100 Series - User Guide - Page 168

Service information form WHO IS RETURNING THE EQUIPMENT? Date: Person to contact: Phone: ( ) Alternate contact: Phone: ( ) Return shipping address: Special shipping instructions: WHAT IS BEING SENT? Model name: Model number: Serial number: Please attach any relevant print-outs when returning equipment. DO NOT ship accessories that are not required to complete the repair (manuals, cleaning supplies, etc.). WHAT NEEDS TO BE DONE? (Attach a separate sheet if necessary.) 1. Describe the conditions of the failure. (What was the failure? What were you doing when the failure occurred? What software were you running? Is the failure repeatable?) 2. If the failure is intermittent, how much time elapses between failures? 3. Is the unit connected to any of the following? (Give manufacturer and model number.) Personal computer: Modem: Network: 4. Additional comments: HOW WILL YOU PAY FOR THE REPAIR? ❏ Under warranty Purchase/received date (Enclose proof of purchase or receiving document with original received date.) ❏ Maintenance contract number ❏ Purchase order number Except for contract and warranty service, a purchase order number and/or authorized signature must accompany any request for service. If standard repair prices do not apply, a minimum purchase order is required. Standard repair prices may be obtained by contacting an HP-authorized Repair Center. Authorized signature Phone Billing address: Special billing instructions: 166 Chapter 5 - Service and support EN