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End User Information
Company Name:
*
Branch Name:
Country:
*
Address 1:
*
Address 2:
*
ZIP Code:
*
TEL Number:
*
FAX Number:
*
Person In Charge:
*
E-mail:
*
E-mail (Re-input):
*
Distributor Information
Company Name:
*
Country:
*
Address 1:
*
Address 2:
*
TEL Number:
Person In Charge:
Printer Information
You can enter up to 5 printers on this form
Printer 1
Model Name:
*
Serial Number
*
Specifications
Standard
Cutter
Dispenser
Others
Date of Purchase(DD/MM/YYYY)
*
Country installed
*
Printer 2
Model Name
Serial Number
Specifications
Standard
Cutter
Dispenser
Others
Date of Purchase(DD/MM/YYYY)
Country installed
Printer 3
Model Name
Serial Number
Specifications
Standard
Cutter
Dispenser
Other
Date of Purchase(DD/MM/YYYY)
Country installed
Printer 4
Model Name
Serial Number
Specifications
Standard
Cutter
Dispenser
Date of Purchase(DD/MM/YYYY)
Country installed
Printer 5
Model Name
Serial Number
Specifications
Standard
Cutter
Dispenser
Other
Date of Purchase(DD/MM/YYYY)
Country installed