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| pL product: |
Product No. *
(according to nameplate) |
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Series No. *
(according to nameplate) |
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Date commissioned *
(put into operation for the first time) |
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Day / Month / Year
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| End customer's/user's details: |
| Name of company * |
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| Street address * |
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| Country * |
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| ZIP/Postal code * |
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| Town/City * |
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| Industry * |
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| (other sector) |
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| Person to contact: |
| Last name * |
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| First name * |
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| E-Mail * |
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| Phone * |
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Technician who commisioned the system/put it into initial operation:
(in the event of a retrofiting contract = end customer's technician) |
| Last name * |
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| First name * |
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| E-mail * |
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| Phone * |
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Same address as the end customer's address
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Machine designation: |
Make: *
(e.g. Deckel Maho) |
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Type: *
(e.g. DMC 835 V) |
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| CNC control system: |
Make: *
(e.g. Siemens) |
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Type: *
(e.g. 840d) |
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Suggestions for improvement/Complaint:
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| Please contact me! |
| Phone: |
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*Mandatory fields:
must be filled out |
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