Isel ICP 4030 - Page 27

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isel- Ê«>VÌÊµÕ«iÌÊÊ*
-iÀÛViÊÜ>ÞLÊ(please, also consider the notes to the next page)
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Company
Customer No.
Contact person/Dept.
Phone Fax
Postal address
Return to
Invoice No./
Qty. Item number Designation Delivery Note No Serial number
(please add copy)
>ÕÃiÊvÊÌiÊV«>Ì
a) Financial complaint H wrong delivery H variance of quantity
H ________________________________________
b) Technical complaint
Error description
When does the fault occur?
H permanently H temperature dependent
H sporadic H after ___ minutes of operation
Was the item already in use?
H has not yet been used
H defect during commissioning
been in use for __ months
Date Signature