Service Order

 

Order by

Company Name*

Company Street*

Company Postcode*

Company City*

Country*

Your VAT No.*

Email-address for e-invoicing*

Purchase order number

 

Contact Person

Name*

E-Mail*

Phone*

Fax*

 

Report to be sent to

Names of persons*

 

Invoiceadress

Company

Street, Nr.

Postcode, City

Country

Invoice additionally by mail

yes

 

Work to be started

Date*

 

Approx. finish

Date

 

Issue/Task of order

Part names*

Description of fault*

Work instruction*

 

Location

Action to be done at*

Contact person*

Contact phone*

Contakt E-Mail*

 

Rework, Sorting

Trained personnel, number of persons

Personal with specific qualification

Shift, please specify

Special tools/equipment

Special safety gear

Special safety measures

Remarks

Attach documents

Bitte nicht ausfüllen*

 

 

 

By placing your order, you accept that you will be responsible for the costs incurred by third parties in carrying out this order (for example, logistics costs). These costs will be charged to you by BUTSCH GmbH with a service surcharge of 5%.

 

yes, read and accepted

 

 

 

gtc & privacy

With my order I declare that I have read the general terms and conditions and the privacy information of Butsch GmbH and accept it.

 

yes, read and accepted

 

reset send service order