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All fields with an asterisk (
*
) are required
Equip ID Number (This is located on the Watts sticker on your machine.)
*
If no Equip ID #, enter model & serial #
Your Name
*
Your Business/Organization’s Name
*
Email
*
Phone
*
Address
*
Floor/Department
City
*
State
*
Select State*
IL
IA
MO
Meter Read
Equipment Type
*
Select Equipment Type*
Floor Model Copier/MFP
Desktop Multi-Function Printer
Printer Only
Is your system operable?
Yes
No
Is the system indicating Preventative Maintenance is due?
Yes
No
Which option listed below best describes your machine's problem? (Check all that apply)
Service Code On Display
System Making Unusual Noise
Poor Image Quality
System Misfeeding/Jamming
Finisher/Stapling Problems
Document Feeder Problems/Misfeeding
Problems Printing (versus walk-up copying)
Other—Please describe below
Provide any details that may assist in solving the issue
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