PBI SAS SUPER IAQ - Authorization and Return; Return Authorization Form

“SAS Super IAQ” Rev. 1 Pg. 34
ENGLISH
To the attention of: Technical department International PBI S.p.A.
Via Novara, 89 - 20153 - Milano - Tel + 39 02/48.779.1-Fax +39 02/400.900.10
AUTHORIZATION RETURN NUMBER TO BE ASKED TO THE EXPORT DPT
Company:
Address:
City: Zip Code State
Phone Fax Email
Name to contact:
Lab/Division:
 return  request of technical service
Equipment:
Model Serial Number:
for
 calibration  repair  other (specify)
NOTE OF MALFUNCTIONING
 ELECTRONICAL PART
 MECHANICAL PART
NOTES:
ATTENTION: THE INSTRUMENT MUST BE SENT TO
INT.PBI C/O STATIM VIA SAN GIUSTO 85 20153 MILANO ITALY
SIGNATURE NAME DATE
Mod. PQ09.9