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Pre-Installation Form

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Pre-Installation Form

In an effort to provide the highest level of customer service, please complete this form to the best of your ability. If you are unable to complete this form, we request that your network administrator be present at the time of installation, or at the very least, available to be reached by phone. Thank you!


Company Name:
IT Administrator:
IT Contact Number :
General Connectivity
Effective Protocol: (Check All That Apply)
TCP/IP		SMB
NetWare		AppleTalk
DHCP: (Check One)
Enabled		Disabled
Network Operating System:
Server IP Address:
Copier IP Address:
Subnet Mask:
Gateway Address:
DNS Server 1:
DNS Server 2:
DNS Server 3:
WINS Configuration: (Check One)
On		Off
Primary WINS Server:
Secondary WINS Server:
Scan to Email Settings
SMTP Server IP Address or Host Name:
SMTP Port #:
SMTP Authentication: (Check One)
On		Off
SMTP Authentication User Name:
SMTP Authentication Email Address:
SMTP Authentication User Password:
Additional Comments or Instructions