Xerox Service Agreement Validation

Important: Your product must be in working order prior to purchasing a Service Agreement.

If your product has not been covered by the original manufacturer's warranty or a Xerox Service Agreement for 30 days or more, you must submit a product Configuration Page. For ease of processing, please write your Service Agreement Item number and your Service Agreement Validation number on the configuration page and send to Xerox using one of the following methods:

 Fax : 866-226-3012
Mail : Xerox Corporation
          Attn - Contract Research
          400 Main St
          Suite 2040
          Saint John, NB E2K 4N5

Please do not use this form for service requests.

To get back to the Services Home Page click here.

An asterisk * indicates a required field.



CUSTOMER INFORMATION

* First name:


* Last name:


* Company Name:


* Email Address:


* Phone Number (include area code):


* Fax Number (include area code):


* Reseller Name:


* Address where product is located:


* City:


* State/Province:


* Zip/Postal Code:


* Service Agreement Item:


* Service Agreement Validation Number:


* Service Agreement Purchase Date (proof of purchase may be required):


Yes, please keep me informed about new Xerox office products, and occasional special offers.

Yes, I would also like to receive selected information from companies that offer related products or services.

PRODUCT INFORMATION

* Product Model Number:


* Product Serial Number: (Guide to Finding Your Serial Number)


* Date Product was Purchased:


Additional comments:


Don't forget to fax or mail configuration page if required.
   

Information for 2nd product

Service Agreement Item:


Service Agreement Validation Number:


Service Agreement Purchase Date (proof of purchase may be required):


PRODUCT INFORMATION

Product Model Number:


Product Serial Number: (Guide to Finding Your Serial Number)


Date Product was Purchased:


Additional comments:


Don't forget to fax or mail configuration page if required.
   

Information for 3rd product

Service Agreement Item:


Service Agreement Validation Number:


Service Agreement Purchase Date (proof of purchase may be required):


PRODUCT INFORMATION

Product Model Number:


Product Serial Number: (Guide to Finding Your Serial Number)


Date Product was Purchased:


Additional comments:


Don't forget to fax or mail configuration page if required.
   

Information for 4th product

Service Agreement Item:


Service Agreement Validation Number:


Service Agreement Purchase Date (proof of purchase may be required):


PRODUCT INFORMATION

Product Model Number:


Product Serial Number: (Guide to Finding Your Serial Number)


Date Product was Purchased:


Additional comments:


Don't forget to fax or mail configuration page if required.
   

Information for 5th product

Service Agreement Item:


Service Agreement Validation Number:


Service Agreement Purchase Date (proof of purchase may be required):


PRODUCT INFORMATION

Product Model Number:


Product Serial Number: (Guide to Finding Your Serial Number)


Date Product was Purchased:


Additional comments: