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 TECHNICAL SUPPORT REQUEST FORM   DATE:
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ORIGINATOR DESCRIPTION
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COMPANY NAME : CONTACT NAME:  
PHONE (AREA) : FAX # (AREA):  
EMAIL ADDRESS:
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HARDWARE DESCRIPTION
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MOTHERBOARD  : REVISION #:     BIOS:#401A0-
CPU BRAND    : SPEED(MHz):
DRAM BRAND   : SPEED(ns) :     SIZE(MB):
CACHE BRAND  : SPEED(ns) :     SIZE(KB):  
HARD DISK    : MODEL NAME:     SIZE(MB): 
CDROM BRAND  : MODEL NAME:
BACKUP BRAND : MODEL NAME:     SIZE(MB): 
OTHER STORAGE: MODEL NAME:     SIZE(MB): 
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ADD-IN CARD DESCRIPTION (MODEL NAME/VENDOR)
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(E)ISA SLOT 1:  
(E)ISA SLOT 2:  
(E)ISA SLOT 3:  
(E)ISA SLOT 4:
 PCI-E SLOT 1:
 PCI-E SLOT 2:
 PCI-E SLOT 3:
   PCI SLOT 1:
   PCI SLOT 2:
   PCI SLOT 3:  
   PCI SLOT 4:  
   PCI SLOT 5:  
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SOFTWARE DESCRIPTION
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OPERATING SYSTEM:
APPLICATION SOFTWARE:
DEVICE DRIVERS:
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PROBLEM DESCRIPTION (WHAT PROBLEMS AND UNDER WHAT SITUATIONS)
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