Product Assistance Request Form
Name:
Company:
Address:
Phone:
E-mail:
Hardware Specific Information
Computer:
System memory:
System BIOS rev:
Video card used:
Network Card:
Other cards in system:
Software Specific Information
Operating system:
Matrox SW used:
Compiler:
Fill out only if you are returning a board
RMA #:
Who were you talking to in customer support?
Date board was received:
MOD #:
SER #:
REV #:
PMB #:
PNS #:
Can you reproduce the problem? Yes
Is an error code displayed? Yes
!
!
No
!
!
No
Fax:
CPU:
PCI Chipset:
Resolution:
Network Software:
Rev:
Rev:
Rev:
Date of failure:
These numbers are on the label at the back of the board.
If so, what code?
... Continued on reverse
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