Handover Declaration

Please complete this form fully on delivery of the machine and return it to the distributor within 7 days.
Warranty requests cannot be processed in relation to machines of which the transfer was not proberly
and correctly documented.
(1) Date of delivery
(2) Type:
Maschine-No.: (refer to type plate: #)
(3) Address of customer
Name:
Address:
Postcode:

Town:

__________________________________________________________________________________
Lely International N.V. TSS (Technical Service Support)

P.O.Box 1965 D-38289 Wolfenbttel

(4) The machine shown in (2) was purchased / put into use by me
The operating manual including the EC conformity declaration was delivered to me together
with the machine. I was clearly instructed in the safety, operating and maintenance
instructions of the machine.
Some components of the machine may have been removed for transportation.
Do not use the machine unless these components have been correctly installed again!

..
Date

Signature of customer

(5) Address of Import Agent and Dealer

Dealer

Company stamp / signature

Company stamp / signature

(6) The machine has been delivered to the customer in accordance with the manufacturers
instructions.
..............................

............................................................

Date

Signature of the Customer Service Specialist

__________________________________________________________________________________
Lely International N.V. TSS (Technical Service Support)

P.O.Box 1965 D-38289 Wolfenbttel