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Appendix E — Problem Report Form
Customer Return Address
Name _______________________________________________________________
Company ____________________________________________________________
Address _____________________________________________________________
____________________________________________________________________
____________________________________________________________________
City________________________________ State ____ Zip _________ — ______
Phone ( ) ______________________________________________________
Equipment Description
Camera Serial Number ________________
(See the bottom of the camera next to “S/N.”)
Problem Description
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Problem Report Form G
