Appendix C: Intel® Server Issue Report Form
Note: An on-line / automatic submission version of this form is available at http://
support.intel.com/support/motherboards/server/chassis/SR1500/. For the fastest service,
please submit your form via the Internet.
Date Submitted: _______________________________________________________
Company Name: ______________________________________________________
Contact Name: ________________________________________________________
Email Address: _______________________________________________________
Intel Server Product: ___________________________________________________
Priority (Critical, Hot, High, Low): _______________________________________
Brief Problem Description. Provide a brief description below. See the last page for space
to include a detailed problem description.
____________________________________________________________________
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Board / Chassis Information

Baseboard Revision - PBA#: _____________________________________________
Baseboard Serial Number: _______________________________________________
Chassis Model:________________________________________________________
CPU1 Speed/Stepping/Spec: _____________________________________________
CPU2 Speed/Stepping/Spec: _____________________________________________
System BIOS Version:__________________________________________________
HSC Firmware Version:_________________________________________________