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Service information form
WHO IS RETURNING THE EQUIPMENT? Date:
Person to contact: Phone:
Alternate contact: Phone:
Return shipping address:
Special shipping instructions:
WHAT ARE YOU SENDING?
Model name:
Model number: Serial number:
Please attach any relevant printouts. Do NOT ship accessories (manuals, cleaning supplies, and so on) that are not required to complete
the repair.
HAVE YOU REMOVED THE PRINT CARTRIDGES?
You must remove them before shipping the printer, unless a mechanical problem prevents you from doing so.
[ ] Yes.
[ ] No, I cannot remove them.
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. If the unit connected to any of the following, give the manufacturer and model number.
Personal computer:
Modem: Network:
4. Additional comments:
HOW WILL YOU PAY FOR THE REPAIR?
[ ] Under warranty
Purchase/received date:
(Attach 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 can be obtained by contacting
an HP-authorized repair center.
Authorized signature:
Phone:
Billing address:
Special billing instructions:
ENWW Service information form 211