[BMER-G01] Tracking Form
Staff name:
Issue description (select all that apply):
no receipt printed
incorrect change amount returned
will not accept bills
out of service screen displayed
receipt print is illegible
blue screen displayed
screen is frozen
windows error box displayed; screen details:
no change returned
other, please explain:
damaged component
Transaction time:
:
am
pm
Customer mobile number:
/
Not applicable
Rate plan selected:
UNLTD
PAYGO RTR
PAYGO PIN
Payment or PIN amount:
/
Not applicable
Cash amount inserted into kiosk:
/
Not applicable
Select all denominations used for payment in the transaction:
$1
$2
$5
$10
$20
$50
$100
How much change was returned:
Did the kiosk complete the transaction?
Yes
No