| Repair Information |
| Please fill out one of the following two options. * |
| You are reporting trouble on telephone number (4 digit ext.) |
You are reporting a Frontier payphone in trouble: |
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| Location of Trouble: |
| Building: |
Room: |
Other Location: |
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* |
* |
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| Please insert the date the problem started: |
Please insert the time the problem started |
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* |
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