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Failure Notification Form
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  Home | Service | Failure Notification Form
   
  Contact
     * Date of Failure Notification
     * Name
       Company
     * Phone
    E-Mail
    Address / Province
    Message
       
  Devices and Failure Information
     * Brand and Model
    Serial No
    Battery Type And Number
    Date Purchased
    Address
       
     * Depending on the electronic equipment and number
     * Observed problems
    Alarms