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#________________

“IMPORTANT” PLEASE FILL THIS FORM OUT COMPLETELY:

COMPANY NAME:____________________________________________________________________

SHIPPING ADDRESS:_________________________________________________________________

_________________________________________________________________

CONTACT NAME:____________________________________________________________________

PHONE #__________________________________FAX #_____________________________________

EMAIL ______________________________________________________________________________

INSTRUMENT TYPE _________________________________________________________________

S/N (S)

_____________________________________________________________________________

Please explain the problem (s) that you are experiencing with the instrument.

Please indicate if you would like information on the following CETAC products.

___ Aridus II Sample Introduction System

___ ASX-110/112FR Autosampler

___ ASX-130 Autosampler

___ ASX-260 Autosampler

___ ASX-520 Autosampler

___ ASX-520HS High Speed Autosampler

___ ASX-1000 Series Oils Autosampler

___ EXR-8 Extended Rack Autosampler

___ LSX-266 Laser ablation system

___ LSX-213 G2 Laser ablation system

___ M-7600 Mercury Analyzer (AA)

___ M-8000 Mercury Analyzer (AF)

___ SDS-550 Sample Prep Station

___ U-5000AT+ or U-6000AT+ Ultrasonic Nebulizers

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