I have answered the above questions to the best of my knowledge.
Name:
Company:
Date:
Signature:
Return Form
Declaration of potential hazards in the enclosed products from exposure to chemicals
We can only accept and carry out the service order if this declaration is filled out completely.
Please include it with the shipping documents.
If you have any questions, please contact our repairs department in Berlin.
RMA number
(can be obtained by c49 30 80 191-233):
Customer information
(must be completed if no RMA no. available):
Company:
Address:
Contact:
Tel./E-mail:
Information on the product:
Product name:
Serial number:
Included accessories:
Knick Elektronische Messgeräte GmbH & Co. KG, Beuckestraße 22, 14163 Berlin, Germany
Phone +49 (0) 30 801 91 - 0 / Fax +49 (0) 30 801 91-200
E-mail:
/ Internet: www.knick.de
The product being returned is new/unused or
has not been exposed to hazardous substances.
The product has been exposed to hazardous substances.
Please preferably state the classification of the hazardous substance, as applicable together with the
H-phrases (or R-phrases), or at minimum provide the relevant hazard pictograms:
The product has been exposed to infectious substances.
The product was subjected to suitable cleaning procedures
to prevent exposure to hazards prior to return.
The product was not freed of hazardous substances prior to return.
Declaration of Contamination
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