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REPORT FAULT
Customer No:
Company:
Contact Person:
Telephone:
E-mail:

1. General Information

Please state the serial number or PIN number on the card
Serial Number: PIN-Number:
Please indicate where you are calling fro
I’m calling from :
Please state the destination number
I am trying to call the following number:
 

2. Error specification

2.1 The dial-up access number doesn’t work


Error report after entering PIN
Error report when entering dial-up      access number
2.2 No Connection

Report that destination number is      incorrect
Line is always busy
Report that destination number is      not available
2.3 Poor quality connection
Echo
The line breaks up
One-sided connection
Crackling, Noise
2.4 Other Problems
Please describe the nature of the problem in as much detail as possible