Service Requested*

Request Supplies
Request Service/Repair
Recycle Toner
Submit Meter Reads
Account Updates and Equipment Moves
Contact Customer Service

Date*

Company Name*

Department/Mail Stop

Name*

First Last

Phone*

Email*

Address

Street Address City State ZIP Code

Equipment ID(s)*

(FlexPrint Printer ID Number)

Toner Requested*

Toner Color	Quantity

Please List the Toner Color & Quantity Needed. To add additional toner requests, press the + button

Comments / Parts Description

Equipment Make & Model

Description of the problem/issue - Why do you need service on this device?*

Recycle Toner

Special Note: When requesting a PREPAID shipping label to recycle your toner/ink cartridges, you may notice a different name and telephone number populating in the “Sent From” section of the form than what you filled in. This is occurring because there are multiple names and numbers tied to the same address. We are aware of the problem, and are in the process of fixing the glitch. In the meantime, please disregard the auto populated name and number. Your empty cartridges will still be sent to the appropriate place for proper recycling.

42,751 cartridges recycled since Nov 2011

Equipment Meter Reads*

FlexPrint Asset ID#	Total Page Count	B/W Page Count	Color Page Count

To enter meter reads for more than 1 asset, click the + button.

Type of Account Update & Equipment Move*

Equipment Relocation To New Address
Equipment Move To New User @ Same Address
New Address To Add To Contract
GL Code Updates
Retire Equipment (Submit Config)
Request To Add Equipment (Submit Config)

Equipment Move Form

FlexPrint ID#	Printer Make/Model	Old Location Description	New Location Description

To list additional equipment move updates, click the + button.

Please enter comments below, so we can direct your request or questions to the appropriate department.*

New Address To Add To FlexPrint Contract*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Equipment ID(s)*

(FlexPrint Printer ID Number)

GL Code Update

New Equipment Make & Model

New Equipment Location/Description

Please send some FlexPrint Printer ID Labels

1
2
3+

Equipment Make & Model to be Retired

Original location of Retired Equipment

Submit Printer Configuration Report*

Max. file size: 50 MB.

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Nossaman LLP

Recycle Toner

42,751 cartridges recycled since Nov 2011