47
ENG
Repairs Contract / Notication of Damage Claim
Device Details
Product Name: Multipress 10.1
Serial Number: _______________________________________
Date of Purchase: _____________________________________
Accessories: _________________________________________
Type of Use:
Private Use
Personal Details
Company: ___________________________________________
First Name: __________________________________________
Street: ______________________________________________
Post Code / Town/City: _________________________________
E-Mail: _____________________________________________
Fax. No.*: ___________________________________________
Product Group: Weight Machine
Invoice Number: ______________________________________
Where Purchased: ____________________________________
________________________________________________
Commercial Use
Contact Person: _______________________________________
Second Name: ________________________________________
House Number: _______________________________________
Country: _____________________________________________
Tel.No.: _____________________________________________
Mobile No.*: __________________________________________
*These details are optional; all other details are obligatory and must be lled-in.
Description of Fault
Please give a short and as accurate as possible description of the fault:
(eg. When, where and in what way did the fault occur. Regularity, and for what lenth of time, and in what form of use, etc ...)
A copy of proof of purchase / invoice / receipt is attached.
I acknowledge the General Business Terms and Conditions of Maxxus Group GmbH & Co. KG.
I hereby instruct the company Maxxus Group GmbH & Co. KG to repair the above-mentioned fault.
In Warranty cases I will not be charged for the costs. The costs for repairs which are excluded from liability for defects in quality will be
charged to me and must be settled immediately. In cases of repairs carried out on site, our sta are entitled to collect payment. This
agreement is conrmed with here with my signature.
Date Location Signature
Please be aware that contracts can only be processed if this form has been completed in full. Be sure to attach a copy of your pur-
chase invoice. Send the fully completed Repairs Contract / Notication of Damage Claim to:
Post*: Maxxus Group GmbH & Co KG, Service Department, Zeppelinstr. 2, 64331 Weiterstadt
Fax: +49 (0) 6151 39735 400
E-Mail**: customerservice@maxxus.de
* Please stamp with sucient postage – letters which are not sent postage paid will unfortunately not be accepted.
** Submission by E-Mail is only possible as a scanned document with original signature.