DAC International Equipment Problem Report

Please fill out the following form. When complete please click the <submit> button to send the completed form to DAC International. You will receive a confirmation when the form is successfully sent.

Company Name*: Contact Name:*
Phone#:* Fax #:
E-mail:* City / State / Country:
Select type of equipment with problem.*
Other: (Please Describe)
Equipment Serial #:
Type of Problem: *
(Select One)		 Hardware or Electrical Problem
Software / Applications Question or Request

Detailed Description of Equipment Problem:

(Please include a description of the problem, along with the steps taken to correct the problem prior to contacting DAC. Please try to reconstruct the problem in a sequential way, such as: "I noticed bad surfaces, so I changed the diamond tool and carefully recalibrated the lathe, etc.")

*


This form will be automatically e-mailed to DAC after you click the <submit> button below. Please wait for the confirmation message to appear after clicking.

You may also print this completed page and fax it DAC to (805) 566-2196