Service and Warranty

Customer Service Form

Date

Ref No.

By

PO#

Service

Contract

Customer

Electra Link Office

 Voice/Data Service

 Audio/Visual Service

Billing Address

Job Site

Customer Contact

Title

Phone

Fax

E-mail

Start Date

Completion Date

Last Tech Out

Pin Out  

Product Type

Cable Type

Jack Type

Cable Type

Jack Type

 Other

Color

Description of Work

Special Instructions

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