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Appendix H — Problem Report Form
KODAK Professional RFS 3570 Film
Scanner
Customer Return Address
Name _______________________________________________________________
Company ____________________________________________________________
Address _____________________________________________________________
____________________________________________________________________
____________________________________________________________________
City________________________________ State ____ Zip _________ — ______
Phone ( ) ______________________________________________________
Date ________________________________________________________________
Equipment Description
Scanner Serial Number — ______________________
(See back of Scanner under “Serial Number.”)
Return Authorization Number ______________________
Provided by the Kodak. Refer to “Appendix G — Repacking Instructions” for additional information.
Problem Description
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Problem Report Form G
