If your equipment requires service, you may use this form to submit a request. Please be as specific as you can concerning your service issue: Person Requesting Service: Billing Customer Name: Phone Number: E-Mail Address: Purchase Order No. (if needed): Location Name: Location Address: On-Site Contact Person (if different from above): Equipment Needing Service: RNB Assigned Asset # (if known): Manufacturer: Designa Federal APD IDenticard Alvarado Commend Delta Digital Payment DoorKing Hamilton Liftmaster SecuraKey Talk-A-Phone Transcore Other Type of Equipment: Magstripe Barcode Software Other Description of the Problem (Be Detailed): Intermittent or Consistent Problem? What Might Have Caused the Problem? Lightning Power Surge Water Damage Hit by Vehicle Vandalism or Misuse Do Not Know Have you Attempted to Repair the Defective Unit? Yes No Please Describe: Other Pertinent Information/Instructions:
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