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If your machine was bought used from a 3rd party please schedule infield services with Paxiom Service here – paxiom.com/book-field/

Name*
First Last
Email*
Company*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Sales Offer #
I have received my purchased equipment*
- Yes
- Not yet
I have bought equipment*
- New from us
- New from a re-seller / distributor
- Received from another facility
- Used from a 3rd party
Please specify the name of your distributor
Please specify which facility
Please specify the 3rd party you've received your used equipment from
My equipment*
- Is a standalone machine
- Is a system

If your machine was bought used from a 3rd party please schedule infield services with Paxiom Service here – paxiom.com/book-field/

Name*
First Last
Email*
Company*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Sales Offer #
I have received my purchased equipment*
- Yes
- Not yet
I have bought equipment*
- New from us
- New from a re-seller / distributor
- Received from another facility
- Used from a 3rd party
Please specify the name of your distributor
Please specify which facility
Please specify the 3rd party you've received your used equipment from
My equipment*
- Is a standalone machine
- Is a system

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Parts Number	Description	Qty

Parts Number	Description	Qty