The back of the Warranty Certificate
Filled by the Executant
Goods accepted for warranty service
(Name of the company-manufacturer, which performs warranty service, legal address)
Date of warranty claim
(Year, month, date)
The number under which the device is taken for warranty
(Surname, first name, patronymic of the responsible person of the Executant) (Signature)
Stamp here
Accounting for maintenance and warranty repair work
Date
Malfunction
description
Works performed, name and type of
replaced parts and assemblies
Executant’s
signature
Warranty period is extended
until 20 until__________20___
until 20 until__________20___
(Surname, first name, patronymic of the responsible person of the Executant) (Signature)
Stamp here
The device is discounted
(Date and number of the device discount act)
New price
rubles
(Amount in words)
(Surname, first name, patronymic of the responsible person of the Executant) (Signature)
Stamp here
25
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