iPulse Fault Report Form

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iPulse Fault Report Form Powered By Docstoc
					   Biometric Reader
   Fault Report
   Please complete this form in full and email back to us at
   your earliest convenience.


   repair@iPulse.co.za
   Please note that no repairs can be initiated until this form
   has been received by our technical team.


   Contact Person
   Name                                                  Position

   Tel (work)                                            Fax (Work)

   Cellphone                                             E-Mail

   Company Details
   Company Name


   Delivery Address
                                                                            Code

   Biometric Reader Details
   Unit Type                       iDU5 Acc               iDU5 Ent            iPB6 Acc             iPB7

   Warranty                 Yes / No     Proof of Purchase                   DD / MM / YYYY

   Serial Number

   Packaging                      Box             Backplate            Pwr Supply          Serial Cable


   Fault Description
   (Full Details)


   Technical Report - Internal Use Only
   Received By                                           Date Received            DD / MM / YYYY


   Fault Repair
   Report


                                  LCD              KeyPad                Sensor            Sensor PCB
   Fault Listing
                                   Main PCB                1-Wire             Network              I/O

   Financial Report - Internal Use Only
   Received By                                           Quote Issued             DD / MM / YYYY

   Quote Number                                          Quote Value

   Customer Order #                                      Collection         Courier   /   Client

   Invoice #                                             System Updated


Telephone: (011) 884-7185                      www.ipulse.co.za                     Facsimile: (011) 884-6840

				
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posted:5/26/2012
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