First Name*
Last Name*
Company Name*
Address 1*
Address 2
City*
Country*
State/Providence*
Zip/Country Code*
Phone*
Email*
Serial Number
Model ---DDF - Direct Die FeederFuji Compatible Label FeederFuji Compatible Tape FeederPanasonic Compatible Tape FeederSiemens Compatible Label FeederSiemens Compatible Single Lane FeederSiemens Compatible Triple-Trac Feeder
Size
# of Feeders Affected
Platform
Platform Version
Approximate Date of Purchase
Notes/Comments
Severity CriticalWorkaround Exists
Issue is ConstantIntermittent
Issue Can be Replicated YesNo
Issue
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