Technical Support FAX Back Form

Aleratec, Inc.

Technical Support Fax Back Form

Please record the following information to help expedite any warranty claim:

Model No.:_ _____________ Serial No.: ____________________________

Date Purchased: ________________________________________________

Place of Purchase:_______________________________________________

To: Technical Support Group FAX: 1-818-678-0483

FROM:_ _____________________FAX: ____________________________

E-MAIL: _ ____________________________________________________

RE:_ ________________________TEL: ____________________________

DATE:________________# OF PAGES: ____________________________

I am experiencing the following problems with my RoboJet Disc AutoPrinter:

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

By answering these questions, your problem will be solved more rapidly. Make copies as necessary. You can reach us electronically at: www.aleratec. com on the internet.

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