Revision: 1.0 Date: 1999-09-01
Field Failure Report
Name of Distributor :…………………… Report # …………………......
Warranty ( ) Yes ( ) No Failure ( ) Intermittent
( ) Persistent
Product : ……………………… Serial number: ………………..
Failure Symptom
: (
Pls refer to the service manual for the symptom of
failure. )
………………………………………………………………………………….
………………………………………………………………………………….
………………………………………………………………………………….
Cause of Failure
:
………………………………………………………………………………….
………………………………………………………………………………….
………………………………………………………………………………….
Parts Replaced
*
: Suggestions to prevent
Failure :
…………………………………….. …….……………………………….
…………………………………….. …….……………………………….
…………………………………….. …….……………………………….
*
When parts needed please fill out a Parts Order Form as detailed as possible.
Date : Place : Prepared By : Company
Stamp :
……………. ……………… ……………… .………………….