...................... .................... ........................... .............................. .......
......
Remark:
Please refer to the spare part kit for all the information that are to be filled out
above.
Date
Stamp
............................
Warranty Claim Form
no: ........................
Dealer Name: ..................................................
of ...........Pages
MODEL
SERIAL NUMBER
Place
............................
DESCRIPTION OF DEFECT
Signature
.....................................
Claim
Revision: 1.0
Company
Page ..........
PARTS #
QTY
Date: 1999-09-01