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______________________________________________________________
Contact Name:
______________________________________________________________
Company Name:
Street Address:
______________________________________________________________
City:
__________________________ Province/State:
Country:
__________________________ Postal/Zip Code:
Phone Number:
__________________________ Extension:
Fax Number:
__________________________ E-Mail:
Serial Number
Fax this form to Kontron's Technical Support department
Failure or Problem Description
in North America at (450) 437-0304
in EMEA at +49 (0) 8341 803 339
B-4
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Manufacturer
Authorization Request
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P.O. #
(if not under warranty)
AM450x User's Guide
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