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General Information

Use the following table to provide general customer information.

Information

Your Response

Date of Incident

 

Incident Number
(to be supplied by CA Technical Support)

 

Customer Name

 

Site ID

 

Customer Address

 

Customer Telephone Number

 

Customer email Address

 

CA XCOM Data Transport Platform, Version, Release, and Maintenance

 

Customer Support Contact
(to be supplied by CA Technical Support)