HygroMatik C01 KIT - 10 Fax Form - Order for Spare Parts

Page 55
10. Fax Form - Order for spare parts
HygroMatik GmbH
Lise-Meitner-Str. 3
24558 Henstedt-Ulzburg
Tel. +4904193/895-0
Order of spare parts
unit type *______________ serial no.* ___________________
commission: ______________ order no.: __________________
date of delivery ____________forwarder _____________ shipment by ___________
delivery address (if different
from invoice address)
__________________________
__________________________
__________________________
__________________________
* Order can only be processed if unit type and unit serial no. are filled in.
quantity article article no.
Fax Form
Please copy, fill in and fax to
Fax.No. +49(0)4193/895-31
company stamp (delivery adress)
date/signature