SERVICE TICKET SUBMISSION FORM
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Contact Information
Provide your details so we can reach you about your request
Company Name
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of the main contact
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
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Machine Information
Enter information about the machine involved, including model and serial number
Type of machine
*
Cartoner
Case Packer
Conveyor
Flow Wrapper
Horizontal Form Fill & Seal (HFFS)
Jar / Container Indexer
Multihead Weigher
Palletizer
Pre-Roller
Pre-Made Pouch Bagger
Product Counter
Tray Sealer
Vertical Form Fill & Seal (VFFS)
Other
Select multiple machines by holding Command (Mac) or Ctrl (Windows) while clicking.
If you selected "Other," please specify
Model of the machine
Located on the nameplate attached to the machine.
Serial number of the machine
Located on the nameplate attached to your machine.
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Issue Details
Describe the problem, error, or request in as much detail as possible
Brief description of the issue
Tell us more about the product you're running
Is this a recurring issue? If so, how frequent does this issue occur?
What steps have been taken to attempt to fix the issue?
Additional information or comments
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