Date Issue Started .

Type of socket (NTE5, None NTE5, Star Wiring).

Tested in Master Socket .

Tested in Test Socket .

Tested with Corded Phone .

Tested with Alt Phone .

Intermittent/permanent .

Specific Group (International, Mobiles, Local, National & All) .
Example Calls
CLI -
Date –
Time - 
CLI -
Date –
Time - 
CLI -
Date –
Time – 

Copper Line Test result .

If fail then result with CPE removed .

TAM Result .

TRC’s Confirmed and Accepted .

Alt Contact No -
Additional Diagnostics done: