Printer Support Request Form

Complete this form to submit a printer support request. All fields marked with an asterisk (*) are required.

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Important Notice

PDC Software does not provide support for printers over 5 years of age.
If PDC Software did not quote and supply the printer, we will assist only on a best-effort basis and assume no responsibility for ongoing issues.
Completion of this form is mandatory before scheduling support. Incomplete forms will be rejected.
This requirement ensures we fully understand the request and allocate resources appropriately.

Printer Company Information

Company Name *

Account Manager / Contact Person *

Phone *

Email *

Customer Information

Customer Name *

Customer Site Contact

Customer Address *

Customer IT Contact (required) *

Customer Phone *

Customer Email *

Printer Information

Make / Model *

Serial Number / Equipment ID *

Year Purchased *

Is printer less than 5 years old? *

Yes

No (If "No," request will be denied)

Network & Configuration Details

IP Address

Subnet Mask

Gateway

DNS Servers

MAC Address

Scan / Print Setup Needs

Select all that apply:

Scan to Email

SMTP, TLS/SSL, Auth details required

Scan to Folder

Full path, username, password, domain

Print Driver Install

Windows, Mac, Server, Other

Fax Setup

Fax configuration needed

Responsibilities

Printer Company / Customer Must Provide:

Network cabling, drops, USB, and patch cables
Administrative credentials for all servers and workstations
Required email server and authentication details
Onsite or immediately available IT administrator

PDC Software Responsibilities (if accepted):

Facilitate connection of the device to the existing network
Install and configure drivers/software within time allocated
Additional labor billed at current hourly rate

Acknowledgement & Liability

By completing this form, the printer company acknowledges that:

PDC Software provides support only as a courtesy for non-quoted printers
PDC Software assumes no liability for loss of time, data, or equipment arising from installation or configuration
Ongoing support will be billable at PDC Software's standard service rates
Requests for printers older than 5 years will be immediately rejected

Authorized Printer Company Representative

Name *

Title *

Date *

I acknowledge and accept all terms and conditions stated above *

By checking this box, you confirm that you have read, understood, and agree to the terms and responsibilities outlined in this form.

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