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Text File  |  1994-04-16  |  1KB  |  63 lines
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  2.              SQWEZ PROBLEM REPORT
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  4.      Please describe problem along with type of equipment:
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  6.      ____________________________________________________________________
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  8.      ____________________________________________________________________
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  10.      ____________________________________________________________________
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  19.  --------------------------[  fold forward first ]------------------------
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  24.     Name    ______________________________________________________________
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  26.     Company ______________________________________________________________
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  28.     Address ______________________________________________________________
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  30.         ______________________________________________________________
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  32.     City    ________________________________State _______ Zip ____________
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  40.  -------------------[ fold back here next and tape closed]----------------
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  44.                                  -------
  45.                                 | place |
  46.                                 | stamp |
  47.                                 | here  |
  48.                                  -------
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  52.               JIM MILLER
  53.               568 GREENWICH AVE.
  54.               PAULSBORO , N.J.
  55.                        08066
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