Reporter Name: 
Reporter Phone: 
Reporter Dept: 
Reporter Email: 
Affected End User Name: 
Affected End User Phone Number: 
Affected End User ID: 

Dept.: 
Location: 
	- Building: 
	- Floor: 
	- Room: 

System: 
Workstation's O/S: 
Possible impact on deadlines if applicable: 

Error message: 

Problem description: 

Has troubleshooting been attempted by the End User, Partner Service Desk or any other support team?  If Yes provide a brief description, If No simply state N/A.

Which mainframe system are they on or trying to connect to? 
Which Environment is the Customer in? i.e.: Production, Testing...
Which Mainframe Application are they trying to access/connect or sign on to? 
How are they connecting? i.e.: TCPIP/Gateway? 
Job # (if applicable)? 
Job Name (if applicable)? 
If running a job what is the Abend Code? 
What are the exact Steps that Customer did before receiving error message? 
What is the Impact that this has for the Customer? 


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