NEC NP100 - Инструкция по эксплуатации - Страница 48

TO: NEC or NEC’s Authorized Service Station: 
FM: 

(Company & Name with signature) 

Dear Sir (s),
I  would  like  to  apply  your TravelCare  Service  Program  based  on  attached  registration  and  qualification  sheet  and  agree  with 
your  following  conditions,  and  also  the  Service  fee  will  be  charged  to  my  credit  card  account,  if  I  don’t  return  the  Loan  units 
within the specified period. I also confirm following information is correct.     Regards.

Application Sheet for TravelCare Service Program

P-1/    , 

Country, 
product purchased :

User’s Company Name :

User’s Company Address : 
Phone No., Fax No. :

User’s Name :

User’s Address :

Phone No., Fax No. :

Local Contact office :

Local Contact office Address :

Phone No., Fax No. :

User’s Model Name :

Date of Purchase :

Serial No. on cabinet :

Problem of units per User :

Required Service :

(1) Repair and Return

(2) Loan unit 

Requested period of Loan unit :

Payment method :

(1) Credit Card   

(2) Travelers Cheque

(3) Cash

In Case of Credit Card : 
Card No. w/Valid Date :

Date:      /       /       ,