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PERKO RGA Number_______________ Serial Number of Xenon Lamp____________
L
AMP
F
AILURE
R
EPORT
XR Series Figure # 9565000
500 Watt Xenon Lamp for Marine Searchlights
This document, when properly completed by the first retail purchaser or his agent of the XR
Series 500 watt Xenon lamp and returned to Perko, Inc., will satisfy the lamp failure report
requirement in the limited eighteen (18) month warranty for XR Series 500 watt Xenon lamps
for marine searchlights.
Date lamp removed from marine searchlight: ______________________________________
Hour meter reading at removal: __________________________________________________
Searchlight Brand: ____________________________Model Number:
__________________
Serial Number: ______________________________
Name of Motor Vessel: ________________________________________________________
Company primarily responsible for searchlight service:
______________________________
Description of failure: __________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Printed name and signature of remover of lamp:
__________________________________
__________________________________
This form must be completed and returned by the person removing the lamp from a marine
searchlight within twenty (20) days from the date on which the lamp was removed. Mail or fax
to:
PERKO, INC
16490 N. W. 13th Ave.
Miami, FL 33169-5707
Fax:1-(305)-620-9978
Phone: 1-(305)-621-7525
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