Contact Information
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*First Name  
*Family/last name  
Company  
Street Address  
Street Address, Continued  
City 
State/Region 
*Zip/Postal Code  
*Country  
Phone  
*Email address  
Fax number  
Hardware Information
*Modem brand  
*Modem type    
*Modem chipset/ Modem Model
Software Information
*Software type   
Software version
You can see this in Help/About in the program.
Please enter the full version number
Serial number 
*Windows version 
*Description

Please describe the problem you are experiencing and the sequence of steps taken to arrive to the error message. Also include the exact error codes and error messages displayed.


 
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