FUJIFILM Business Innovation Malaysia

Relocation Form

  • Current Start
  • Preview
  • Complete
Indicates required field

Please read before filling in

Information message

Please make sure of the following:
This site of the inquiry form is managed and operated by our company.
As our return E-mail is created only for responding to your inquiry, please do not use the information contained for other purposes.
We may not be able to meet your request for a response by a specified date or in the case of urgent inquiries.

Customer Information

Are You Moving Office

Billing Information

Relocation Information

Preferred Pick up Time
Security Clearance Required

Machine Pick Up Information

Staircase
Pickup Contact Person

Machine Delivery Information

Staircase
Delivery Contact Person

Machine Information 1

Software Support Required or Reconfiguration of Device/Workstation

Machine Information 2

Software Support Required or Reconfiguration of Device/Workstation

Machine Information 3

Software Support Required or Reconfiguration of Device/Workstation
Details Confirmation

Information message

Handling of personal information

Please be advised that we will use your personal information, such as your name and email address, which you may provide via this form in order to serve you by sending our response to your inquiry. We may also have occasion to forward your personal information to our affiliated companies and/or distributors of our products and/or services in order to serve you quickly and efficiently. If you agree, please check the box below.

*In order to submit, you must agree to the Privacy Policy.