Site or School
First Name 
Last Name 
Email Address: ( 
Location in building: (Room 204, Office) 
Choose a Repair Department
Equipment Category
Equipment Description 
Property Control Number* (198942E ) or last 5 digits of serial number (ser# xxxxxx) 
Budget Number 
In most cases you will be charged for printer parts. Refurbished parts are always chosen when available. This results in less cost to you. I will use surplus or used parts if available, which then will not be charged back. Please indicate maximum amount permitted to spend, otherwise it is implied you are leaving it up to my judgment.
Description of the Problem