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1. Full Name *
2. Address  
3. City, State, Zip  
4. Phone Number *
5. E-mail Address *
6. Description Of Problem *
   I have Broken or Bad LCD Screen The power connector where I connect the ac adapter is broken ( or lose ) The Laptop does not power on The Laptop does not receive power I get no image on the screen when I turn it on The laptop makes a beeb sound when I turn it on The laptop keep restarting by it self The laptop does not go to the windows I have virus ( or spy ware ) Other ( Please describe )
7. Other  
8. Laptop Make  
   Apple Averatec Compaq Dell Fujitsu Gateway HP IBM Sony Toshiba
9. Laptop Model Number *
10. Security Code: *
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