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Company_________________________________________ Contact____________________________________
Phone________________________Fax___________________________
MANUFACTURER________________________________Approx. Date_________________
Control Unit (Key Service Unit)____________________________
Processor______________Release__________Revision_______________
Printed Circuit Cards:
| Quantity | Part Number |
| __________ | ___________________ |
| __________ | ___________________ |
| __________ | ___________________ |
| __________ | ___________________ |
| __________ | ___________________ |
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Telephone Sets:
| Quantity | Part Number |
| __________ | ___________________ |
| __________ | ___________________ |
| __________ | ___________________ |
| __________ | ___________________ |
| __________ | ___________________ |
| __________ | ___________________ |
| __________ | ___________________ |
FAX Form to 719-687-6115
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