Product Assistance Request Form
Name:
Company:
Address:
Phone:
Fax:
E-mail:
Hardware Specific Information
Computer:
CPU:
System memory:
PCI Chipset:
System BIOS rev:
Video card used:
Resolution:
Network Card:
Network Software:
Other cards in system:
Software Specific Information
Operating system:
Rev:
Matrox SW used:
Rev:
Compiler:
Rev:
Fill out only if you are returning a board
RMA #:
Who were you talking to in customer support?
Date board was received:
Date of failure:
MOD #:
These numbers are on the label at the back of the board.
SER #:
REV #:
PMB #:
PNS #:
Can you reproduce the problem? Yes
No
Is an error code displayed? Yes
No
If so, what code?
... Continued on reverse
Artisan Technology Group - Quality Instrumentation ... Guaranteed | (888) 88-SOURCE | www.artisantg.com
