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 Server are they trying to connect to? 
Has the LAN Admin been contacted to verify if server is up? 
What is the TCP/IP address that they are connecting with? 
What is their TCP/IP address? 
Have they rebooted their system to ensure a clean connection? 
What were they doing before they received the error message? 

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