L2 158004.B00
PRODUCT FAULT REPORT
CUSTOMER INFORMATION PRODUCT INFORMATION
COMPANY NAME: PRODUCT/DOCUMENT:
INDIVIDUAL CONTACT: SERIAL NO:
PHONE NO: DATE OF RETURN:
SYMPTOMS OBSERVED /DOCUMENTATION ERRORS (as applicable):
IN WHAT CONFIGURATION IS THE BOARD USUALLY USED? (WHAT OTHER
BOARDS, WHAT SOFTWARE ETC.)?
FOR DSP DESIGN USE ONLY:
PRODUCT TEST REPORT:
DATE OF RECEIPT: REPAIRED BY:
CHARGES TO BE INVOICED: £
DATE OF RETURN: RETURNED BY:
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