Installation / De-Installation Request

To request installation or de-installation, please enter the information below
and SUBMIT. A service representative will contact you within 24 hours
(Monday - Friday) to confirm your request.      
Notes:   Fields indicated in red are mandatory. 
            Form applicable to Australian / New Zealand customers only.

Contact Name:
Phone Number:
(during business hours)
Mobile Number:
Fax Number:
(include area code)
E-mail Address:
Preferred Method
of Contact:
Company Name:
Your Reference Number:
(for this install/deinstall request)
Installation Site:
(Describe Area or Floor if Applicable)
Address:
Country:
Serial Number:
Printer Model:
Other:
Date of Purchase:

(ie: dd/mm/year)
Supplier's Name:

(ie: Prestige Printers Distribution)
Supplier's Address:

(ie: Lane Cove, NSW, Aust.)
Installation Type:
Installation De-Installation
Installation/
De-Installation of:
Special Instructions:
Multiple Installations:
Identify ALL printer types (name / model) and serial numbers: