User's Guide

www.chiappafirearms.com - 61 - e-mail [e-mail]
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Warranty Service Request Form
Write in the above space the NdR number
that Service Center will notify you
1. Customers details:
• First Name and Surname: _________________________
• Address : ________________________________
• Town : ___________________________________
• ZIP code : ___________________________________
• Phone : ________________________________Reacheable from hour ____ to hour
____
• Fax : ____________________________________ Reacheable from hour ____ to
hour ____
•
2. Product Informations:
• Warranty service request:_______________________
• Modelo : ___________________________________
• Serial Number : ___________________________
3. Dealer:
• Date of purchase : ______________________________
• Name of Dealer/Shop : ____________________
• Address : ____________________________
4. Description of the problem:
• Description of the problem :
____________________________________________________
Documents to include: proof of purchase
Notes:…………………………………………………………………………………………………………………
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NdR :_____________________