HP 2600fx HP SureStore 2600fx User's Guide - Page 40

Additional comments, Thank you.

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Maintenance Contract: number VISA_____ MASTER CARD Credit Card Number Expiration Date Signature Date Purchase order number Billing Address Authorized Signature Phone What needs to be done? Describe the conditions at the time of failure. (What were you doing when the failure occurred? What software were you running? Is the failure repeatable Additional comments Thank you. A-10

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A-10
Maintenance Contract: number __________________________________
_____ VISA_____ MASTER CARD
Credit Card Number _____________________________________________________
Expiration Date _________________________________________________________
Signature ____________________________________ Date _____________
Purchase order number:___________________
Billing Address:
________________________________________________________________
________________________________________________________________
Authorized Signature: ___________________________________________
Phone __________________________
What needs to be done?
Describe the conditions at the time of failure. (What were you doing when the failure
occurred? What software were you running? Is the failure repeatable?)
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Additional comments:
________________________________________________________________
________________________________________________________________
________________________________________________________________
____________________________________
Thank you.