::Office Systems Limited::

Company Name*:

Address*:

District*:

Your Name*:

Mr

Mrs

Miss

Your Telephone*:

Ext:

Your Fax:

Your Email:

Your Maintenance No.:

if necessary

Product*:

Model No.*:

Other (Please specify):

Serial No.*:

Within Warranty*:

Yes No

Service Enquiry*:

(You can select more than one item)

Requisition of maintenance and repair service

Relocation of a machine under warranty (please input your new address in the below box)

Extension of warranty period

Quotation of maintenance

Quotation of inspection charge

Quotation of spare parts (please specify the spare parts number in the below box)

Symptoms/Other enquiries (please specify in the below box)

(Fields with * must be filled)