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__________________
