Highpoint Service Network Sdn. Bhd.

1 Jalan TP6,
Sime UEP Industrial Park,Subang Jaya,
47600 Petaling Jaya, Selangor.

Phone : 60380266226 Fax : 60380245100

SR No.

CORRECTIVE MAINTENANCE SERVICE REPORT

Section A : Service Sign-On
Day Date Time
SU MO TU WE TH FR SA - - : AM PM
Customer Department/Division/Unit Project

Section B : Movement
Depart Destination Distance
KM
KM
Total KM
Section C : Incident Management Ticket No. :
Incident Location Reported by * Contact No. *

Item Tag ID/Description On-Site Contact Person ** Contact No. **

Model : Serial No:

Incident Description

Section D : Request Management Ticket No. :

Project Implementation Preventive Maintenance Inventory Audit
Ad-Hoc Chargeable Standby
Others:
Section E : Service Description

Status Replacement Part/Unit Qty Serial No.

Pending
Resolved
Closed
Section F : Service Rating
Very Satisfied Satisfied Not Satisfied
Comment:
Section G : Service Sign-Off
Day Date Time
SU MO TU WE TH FR SA - - : AM PM
Serviced by Confirmed by Certified by
Signature and Stamp Signature and Stamp Signature and Stamp

Name: Name: Name:

Designation: Designation: Designation: