Service Order

 

Order by

Company Name*

Company Street*

Company Postcode*

Company City*

Country*

Your VAT No.*

 

Contact Person

Name*

E-Mail*

Phone*

Fax*

 

Report to be sent to

Names of persons*

 

Invoiceadress

Company

Street, Nr.

Postcode, City

Country

 

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*

gtc & privacy*

yes, read and accepted

 

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

 

reset send service order