Atlantis Land AO2-F5P Demand of assistance Form, Defect, DateSignature RMA given by ATLANTIS LAND

Models: AO2-F5P

1 10
Download 10 pages 11.04 Kb
Page 8
Image 8

Demand of assistance Form

Fill all the blanks, attach always a copy of the proof of purchase (Sale Receipt or Invoice), and add it all to the product for which you are asking for assistance.

Defect:________________________________________

______________________________________________

Type:_____________ Serial Number _______________

For more information call:________________________

Phone.:_________Fax:__________E-mail:___________

Address for sending and retiring of the defective product: Surname:______________________________________

Name_________________________________________

Corporate name (obligatory for the societies)__________

ZipCode￿￿￿￿￿City__________________Contry￿￿

Street___________________________________n°.:____

Tax Code or VAT Number (you must always write it):

￿￿￿￿￿￿￿￿￿￿￿￿￿￿￿￿

I agree with this with all the clauses of Guarantee, paying particular attention to the restrictive ones, shown by ATLANTIS LAND® for this product.

Date________________Signature___________________

RMA (given by ATLANTIS LAND®):_______________

Consent for the treatment of personal informations. I authorize ATLANTIS LAND® to insert my personal information into its data bank, with the only aim to apply the Guarantee to the product over mentioned and for the future administrative, commercial and statistic management.At any time I will be allowed to ask , according to law 196/03 art.7, to change or to cancell them or to oppose their use informing of that ATLANTIS LAND®, via De Gasperi, 122 – 20017 – Mazzo di Rho (MI). Data________________Signature__________________

Page 8
Image 8
Atlantis Land AO2-F5P Demand of assistance Form, Defect, Type Serial Number For more information call Phone.FaxE-mail