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3 Defect Report Form
Form sheet for repairs and returned goods
S en d er:
* N am e, fir st n am e:
E mail addres s :
* Or d er-/ r efere n ce-n o (ch o os in g at lea st 1 o p tio n):
O rder-no fo r rep air:
In fo rm atio n co n ce rn in g the p ro d u ct an d its u se :
* Or d er C od e (M L F B ):
* C us tom er:
C u sto mer origin al purc has e o rd er num ber:
* T ype o f or d er
(c h oo s in g at leas t 1 o p tio n ):
R e pair
U p grade / Mod ific ation to ...
T yp e o f failu r e:
D e vice or mo dule do es not sta rt up
S porad ic failu re
P erman ent f ailure
R e peat ed brea kd ow n
E rro r d esc rip tio n :
D is pla y m es sa ge:
(us e s epa ra ted she et fo r more info )
A ct iv e LE D m es sa ges :
F au lty Inte rf ac e(s), w h ic h?
* D etailed e rr or d esc rip tio n (p le ase refer to othe r e rror rep orts or doc um entat ion if pos s ible):
* Sh all a firm w a re up d ate be m ad e d u ri ng r ep air o r m e ch an ical u pg r ad e o f p ro tective rela ys? (ch o o sin g at le ast 1 o p tio n )
Y es , to m os t rec ent v ers io n
r ep air rep o rt:
Y es , st anda rd report (free of c harge )
S h ip pi ng a d dr ess o f th e r ep air ed /u p g rad ed p r o du c t:
C o mpan y, depa rtm ent
N a me, f irs t nam e
S treet, n umb er
P os tco de, c ity, co untry
D a te , Sig n atu re
Please contact the Siemens representative office in your country to obtain return instructions.
©2010 Siemens Protection Devices Ltd
(fields marked with * are mandatory fields)
C o mplete pho ne nu mbe r (inc l. co untry co de):
* O rg -ID an d G B K r efere nc e:
o rd er-/ deliv ery n ote-no for return of c omm is s io n
fa ilure:
F irm w are v ers ion :
V
P roduc t w a s in u se approx imate ly sinc e:
D e live ry no te nu mbe r w ith pos it ion num ber:
Re turn o f co mm is sion failure
W arranty repa ir
F or c olle ction
M ec hanic al problem
K noc k s ens itiv e
T em perat ure c aus ed f ailure
F ailure afte r firmw a re upd ate
W rong mea su re d v alu e(s), wh ic h?
No
Y es , det ailed re port (c harge: 400E U R )
7SG163 Ohmega 300 Series Maintenance
C omp lete fax nu mber (inc l. c ou ntry c od e):
* AWV :
B eginning order-no fo r cred it n ote d ema nd:
* S eria l n u m be r:
S tation /proje ct :
M anu fac turer:
C re dit N ote
Qu otation (n ot repa ir V 4 and c urre nt
produc ts ! Se e price s in P MD )
Ov erlo ad
Tran sp ort dam age
Fa ilure af ter ca
Fa ult y inpu t(s )/ou tput(s ), which ?
Yes , ac tua l p arame ters mus t be reus able
Chapter 10 Page 6 of 6
Hotline Inpu t no .:
h rs in us e
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