Service Declaration Form
LIFE365 ITALY S.P.A.
Information Declaration
Declaration Date:
*
/
Month
/
Day
Year
Date
Installation Date:
*
/
Month
/
Day
Year
Date
Information Client
Inspected By:
First Name
Last Name
Company Name:
*
Company Address:
*
Shipping Address:
*
Phone Number:
*
Email:
*
Information Vehicle
Mark:
*
Model:
REF Cable Used:
Information Device
Model:
Serial No:
Under Warranty:
Please Select
Yes
No
Information Fault
Charging possibile:
Please Select
Yes
No
Failure Frequency:
Please Select
Continued
Working
Casual
Smartphone System:
Please Select
Android
IOS
Others
Description of the problem:
Installation Details
Date of Inspection:
*
/
Month
/
Day
Year
Date
Address of Installation:
Installer's Name and Phone number:
Remote Diagnostic solution(log)(if it is done):
Verification and testing of installed Autel Maxicharger
Autel Maxicharger is well installed, not damaged:
*
Please Select
Yes
No
30mA RCD operating time test result:
*
Earth Loop Impedance Test Zs result:
*
Measured line voltage:
*
Autel Maxicharger is powered on and connected to internet:
*
Please Select
Yes
No
Autel Maxicharger is set up on Cloud:
*
No
Autel
Nextcharge
Other
Note: Not mandatory to perform all the test or measurement. It is recommended to do when it is possible.
Photos of Autel Maxicharger
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Notes
Return Request
All the product sold by Autel Distributors, when it should be returned to Autel repairing center for checking and rapairing, it must follow Autel RGA (return goods authorization) process. Please contact local sales or technical support team for the details.
Submit
Should be Empty: