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UMC 112 - Trend Product Marking Systems Australia

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Request for service<br />

of company<br />

Billing address:<br />

Location of machine (if different to above):<br />

Contact: _________________ Department: ________________ Date: ____________<br />

Phone no.: _________________ Fax no.: ________________ Order no.: ____________<br />

Request for<br />

of<br />

Installation Maintenance Repair Training ____________________<br />

Machine:<br />

Laser � Type: _______________________________<br />

Pinmarker �<br />

Scraper � Machine no.: _______________________________<br />

Electrolytic �<br />

Pad printer � Controller no.: _______________________________<br />

Ink Mark �<br />

Year of manufacture: _______________________________<br />

Short description of problem:<br />

______________________________________________________________________________________<br />

______________________________________________________________________________________<br />

______________________________________________________________________________________<br />

______________________________________________________________________________________<br />

______________________________________________________________________________________<br />

Please enclose the completed and signed maintenance protocols!<br />

Other:<br />

Östling Markiersysteme GmbH<br />

Broßhauser Straße 27<br />

42697 Solingen<br />

Tel: 0212 / 2696 - 0<br />

Fax: 0212 / 2696 - 199<br />

Gewährleistung �<br />

Kulanz �<br />

Rechnung �<br />

interne AB: __________<br />

Termin: __________<br />

Monteur: __________<br />

Erledigt: __________<br />

(is completed by ÖSTLING !)<br />

______________________________________________________________________________________<br />

Signature and company stamp: ________________________________________________________<br />

Formular: SG-01 en Änderungsstand: 2 Ausgabedatum: 08.05.2006 Zuständig: SG

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