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notice of defects

applicant

Title *
First name / Surname *
Company
Street
Post Code / City *
Country *
Telephone *
+43
Fax
+43
E-mail *

My details

Assembly carried out by: *
site: *

defect 1

serial number (from to):
pc.
handover date:
brief description / defect:
damage description / reference to picture (number)

Following data must be attached to the form

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Only a fully completed application including a detailed documentation with pictures can be dealt with.

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