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Customer information
Company

Customer numberCompany
Customer name

First nameLast name
Address

Street and house number

Street Address Line 2

CityState / Province

PLZCountry
Phone number

country codearea codephone number
E-Mail
example@example.de
Information about the machine
What type of machine is it?
Serial number (on the underside of the machine)
Purchase date

TagMonatJahr
Date
Proof of purchase or warranty certificate

Cancelof
Describe the problem in detail.
Has the machine been sent in for repair in the past?
If so, when?

TagMonatJahr
Date
repair receipt

Cancelof
Is it the same problem?
Handling of repairs
Up to what amount can repairs be carried out without further approval? (outside the warranty period)
If this amount is exceeded, I request:
I agree that a processing and inspection fee of €47,60 will be charged for each machine sent in that is not covered by a warranty or guarantee claim. The flat fee will be charged in particular if no technical defect can be found or if the defect is due to improper use, lack of maintenance or failure to clean the machine. All prices include statutory value added tax, plus shipping costs. I confirm that I have cleaned the machine in accordance with the operating instructions and checked the items on the checklist before shipping. If it turns out that the machine has not been cleaned and this results in increased testing or cleaning costs, I agree to be charged the corresponding costs.
Should be Empty:

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