Step 1 of 2 - Customer Details 50% Kindly complete all appropriate sections of this form and return it together with the product. Use the "Tab" key to navigate the fields. Complete one form for identical products requiring similar service. Use different forms for different products. If applicable, make sure to send peripherals like external sensors together with each product. Customer Details:Bill to:Contact Name First Last Company Name* Address* Street Address Address Line 2 City State Zip Phone*Email* Ship To: (leave blank if same as “Bill To”)Contact Name First Last Company Name Address Street Address Address Line 2 City State Zip PhoneEmail Product DetailsDate MM slash DD slash YYYY Service Order #: Total n° of units: P.O. #: Product Codes Serial Numbers Product Description:(if no product code)Service Repair Replace Battery Retrieve Data Disposal CalibrationTemperature: Yes No Scale: Celsius Fahrenheit Setpoints: Humidity: Yes No Setpoints: Please check the option that best describes the fault you have encountered: No reply / No COM Low Battery Faulty Readings Error Message (include screenshot): Attach screenshot hereMax. file size: 64 MB.Problem Details (if any): Any service performed on the product: Any Additional Information: Δ
