2962P POWERFLEX SPEEDTILLER OPERATOR & SAFETY MANUAL
57
RESELLER: _______________________ CLIENT: ______________________
ADDRESS: _______________________ _____________________________
PHONE: _________________________ _____________________________
MACHINE MAKE & TYPE: ____________________________________________
SERIAL NO: ______________________ CUSTOMER ORDER NO: _______
INVOICE NO: _____________________ DATE OF INVOICE: ___________
FULL DESCRIPTION: ________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
CAUSE: ____________________________________________________________
___________________________________________________________________
___________________________________________________________________
DATE OF FAILURE: _______________
HOURS WORKED: _____________
DATE OF REPAIR: ________________
HECTARES WORKED: __________
I AGREE:
1. That in accordance with the warranty given by K-LINE AGRICULTURE, I have taken every reasonable
precaution as is commonly expected in this industry in the operation of the machine.
2. This claim is not due to negligence, lack of maintenance, routine wear & tear or accidental damage &
no unauthorized alteration has been made to this machine.
OPERATOR: SIGNATURE ____________________________DATE:_____________________
OWNER: SIGNATURE ___________________________DATE:_____________________
OFFICE USE ONLY:
ACCEPTED:
YES/NO
DENIED:
YES/NO
DATE: ___________________________________ DATE: _____________________________
GOODS REPAIRED/ REPLACED/ REFUNDED FOR
REASON FOR DENIAL: _______________
CREDIT?
(CIRCLE)
___________________________________
REFUND OR REIMBURSEMENT REQUIRED?
_________________________________
CHQ NO/ ADJUSTMENT NOTE NO: ___________
CHANGE REQUIRED? (CIRCLE)
SHIPPING DETAILS: _______________________
DESIGN
APPROVED BY: ___________________________
WORK METHOD
ACTION TAKEN: ___________________________
SUPPLIED PRODUCT
__________________________________________ REFER TO SUPPLIER
CLIENT
SATISFIED
YES/NO
RECALL
REQUIRED
FILE CLOSED BY: _________________________
DATE: _____________________________
W A R R A N T Y R E Q U E S T F O R M
2962P op & safety manual.indd 57
2962P op & safety manual.indd 57
21/03/2020 8:17:42 AM
21/03/2020 8:17:42 AM